Tennessee Department of Health Certificate of Live Birth
This file is the Certificate of Live Birth form from the Tennessee Department of Health. It includes fields for child's information, mother's and father's details, and medical information. It is used for registering the birth of a child in Tennessee.
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How do I fill this out?
Complete the child's details section including name, sex, date and time of birth. Provide the mother's and father's personal information. Fill out the medical and health information section accurately.
How to fill out the Tennessee Department of Health Certificate of Live Birth?
1
Complete the child's details section including name, sex, date and time of birth.
2
Provide the mother's current legal name, name prior to first marriage, date of birth, birthplace, and residence details.
3
Input the father's current legal name, date of birth, and birthplace.
4
Fill in the certifier's signature, title, and date signed.
5
Complete the medical and health information section accurately.
Who needs the Tennessee Department of Health Certificate of Live Birth?
1
Parents registering the birth of their child in Tennessee.
2
Hospital staff responsible for recording birth details.
3
Midwives and home birth attendants documenting birth information.
4
County registrars for maintaining birth records.
5
Health department officials for birth certification purposes.
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What are the instructions for submitting this form?
Submit this form by providing completed details via email to the Tennessee Department of Health at health.vitalrecords@tn.gov, by fax to (615) 741-9860, or by mailing it to Tennessee Department of Health, Division of Vital Records, 710 James Robertson Parkway, Nashville, TN 37243. Ensure all sections are accurately filled. Review for any errors before submission.
What are the important dates for this form in 2024 and 2025?
Important dates for this form include the child's date of birth and the date the form is signed by the certifier and filed by the registrar. For 2024 and 2025, ensure the form is submitted promptly after birth to avoid any delays in the registration process.
What is the purpose of this form?
The purpose of the Tennessee Department of Health Certificate of Live Birth form is to officially register the birth of a child in the state of Tennessee. This form collects essential information about the child, parents, and the circumstances of the birth. It serves both legal and health documentation purposes and is used for creating an official birth record for the child.
Tell me about this form and its components and fields line-by-line.
- 1. Child's Details: Includes name, sex, date and time of birth, facility name, and location of birth.
- 2. Mother's Details: Includes mother's current legal name, name prior to first marriage, date of birth, birthplace, and residence details.
- 3. Father's Details: Includes father's current legal name, date of birth, and birthplace.
- 4. Certifier's Details: Includes certifier's signature, title, and date signed.
- 5. Medical and Health Information: Includes details like mother's medical record number, child's medical record number, newborn screening specimen control number, and facility ID.
What happens if I fail to submit this form?
Failure to submit this form can lead to undocumented birth, causing complications in obtaining legal identity, health benefits, and other services.
- Legal Identity Issues: The child may face difficulties in obtaining a birth certificate, leading to issues in accessing legal documents and identity proof.
- Health Benefits Access: Delayed submission can hinder access to healthcare services and insurance benefits for the child.
- Official Records: Incomplete official records may cause complications for the child in the future regarding education, employment, and travel documentation.
How do I know when to use this form?
- 1. Birth Registration: For official registration of a child's birth in Tennessee.
- 2. Legal Documentation: To obtain a legal birth certificate for the child.
- 3. Health Records: To document health information related to the birth.
- 4. Parental Records: To record details of the child's parents.
- 5. Statistical Records: For state records and statistical data collection.
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