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Connecticut Packet for Amending Sex on a Minor Child's Birth Certificate

Official state formSex designation changeFree downloadLast verified November 10, 2026

Packet for a custodial parent or legal guardian to amend the sex designator on a minor child's Connecticut birth certificate. It has the instructions, the parent's affidavit, the practitioner's affidavit and a birth certificate request. It goes to the Record Replacement Unit.

Who can use this form

  • The custodial parent or legal guardian of the minor child signs the parent affidavit before a notary public.
  • A licensed physician, physician assistant, advanced practice registered nurse or psychologist completes the practitioner affidavit about the child.
  • Any later request to amend the sex on the same birth certificate requires a court order.

What to send with it

  • The notarized affidavit of parent applicant.
  • The notarized affidavit of health care practitioner stating that the minor child has had surgical, hormonal or other treatment clinically appropriate for gender transition.
  • A photocopy of a valid government issued photographic identification, such as a driver's license or passport.
  • If the child has a new name to show on the amended certificate: a certified copy of the court order granting the legal name change.
  • If you want a certified copy of the amended certificate: the birth certificate request in the packet and a $30 money order payable to "Treasurer, State of Connecticut".

Where to send it

Mail to
Connecticut Department of Health Office of Vital Records-Record Replacement Unit 410 Capitol Avenue, MS#11VRS Hartford, CT 06134
State fee
No processing fee for the amendment, according to the office's gender change page. A certified copy of the amended certificate is $30.00, as the packet prints.
Typical processing
Not provided
Form revision
Instructions rev. 12_2021; parent affidavit Rev. 12/2021; practitioner affidavit 12-2023
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Connecticut Packet for Amending Sex on a Minor Child's Birth Certificate | Connecticut Form