PACKET A

SAMPLE: COVER LETTER)

Dear (Physician):

As the attending physician at an out-of-hospital birth, you are required by statute (Health and Safety Code (H&SC ) Section 102415) to register the child's birth with the Local Registration District (LRD).

H&SC Section 102400 states: "Each live birth shall be registered with the local registrar of births and deaths for the district in which the birth occurred within 10 days following the date of event." California law requires birth registration at the local health department to be completed within 10 days of the birth. Any birth registered on or after the child's first birthday must be processed by the Office of Vital Records (OVR) as a Delayed Registration of Birth (VS 85). This requires a statutory tee of $19 (subject to change). If the requirement for a VS 85 cannot be met then it will be necessary to apply for a Court Order Delayed Registration of Birth (VS 108). This form must be processed by OVR. Out of Hospital are increasingly more difficult to register the further from the date of the birth that the registration is attempted

You must see that the parent(s) sign the worksheet in the enclosed packet. You will need to advise the parent(s) of the need to appear with you, or within one week of your appointment with the LDR, so the parent(s) can sign the birth certificate. you, or within one week of your appointment

The out-of-hospital birth packet includes includes a cover sheet, affidavit of birth information form and instruction sheet. READ ALL MATERIAL CAREFULLY AND COMPLETE BIRTH INFORMATION FORM BEFORE YOUR TO REGISTER THE BIRTH.

You will need to set up an appointment to register the birth. It may take up to _________________ from the day you call for an appointment until your scheduled appointment. Please call

( ) ___________________ to schedule your appointment. You may use this telephone number if you have questions regarding the contents of the packet.

Sincerely,

 

Chief Deputy Registrar, Vital Records

County of _____________________

Here's what needs to be brought to the birth registration appointment.

1. The physician and parent(s) must have one valid picture I.D. issued to them by the government, such as:

Driver's license or California I.D. from the DMV (Department of Motor Vehicles)

Passport

Military I.D.

Green Card

If the parents are not here legally, they might be able to obtain an I.D. from their consulate.

2. The physician’s license number. The LRD may call the Medical Board of California at (916) 263-2388 to verify this information

Affidavit of child birth information - PHYSICIAN VERSION.

This form must be completed prior to the appointment. There is no time to do it during the appointment.

Answer every question on the form.

Obtain all necessary signatures.

Call the LRD if you have any questions.

Click below for next section

Packet B
Certified Nurse and Licensed
Midwife-attended home birth