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Connecticut Application for Stillbirth Certificate (VS-7)

Official state formStillbirth and pregnancy lossForm VS-7Free downloadLast verified November 10, 2026

A parent's application to the State Registrar of Vital Records for a Certificate of Stillbirth. It is a commemorative document for a stillbirth of at least twenty weeks gestation and cannot be used to prove identity or for any other legal purpose.

Who can use this form

  • Only the parent of the stillborn can file the application and get a copy.
  • The certificate is for a stillborn fetus that reached at least twenty weeks gestation and died before birth.
  • The application is signed by the mother, the father or both.

What to send with it

  • The completed and signed application.
  • A copy of the parent's valid government issued photo identification.
  • $30.00 per copy by money order payable to "Treasurer, State of CT". Personal checks are not accepted.

Where to send it

Mail to
State Registrar of Vital Records Department of Public Health Vital Records-MS#11VRS 410 Capitol Avenue Hartford, CT 06134-0308
State fee
$30.00 per copy
Typical processing
The office's website says State Vital Records Office processing varies and can be up to 12 weeks. The form does not state a time.
Form revision
6/05;10/1/09
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Connecticut Application for Stillbirth Certificate (VS-7) | Connecticut Form