Florida · Birth

Florida Certificate of Birth Resulting in Stillbirth Application (DH 728)

Official state formStillbirth and pregnancy lossForm DH 728Free downloadLast verified November 10, 2026

Application to order a Certificate of Birth Resulting in Stillbirth, which is created from the fetal death record (20 weeks of gestation or more). It cannot be used for official purposes. It goes to the Florida Department of Health vital statistics office in Jacksonville.

Who can use this form

First issuance: a parent named on the record, a legal representative, or a person with a court order
After the first issuance the record is public and any applicant may apply.

What to send with it

Completed and signed application
Copy of valid photo ID (first applicant)
Attorney bar number and client name, if a legal representative applies
Check or money order payable to Vital Statistics

Where to send it

Mail to: DEPARTMENT OF HEALTH OFFICE OF VITAL STATISTICS ATTN: VITAL RECORDS SECTION P.O. BOX 210 Jacksonville, FL 32231-0042
State fee: $9.00 (non-refundable search fee, includes one certification); $4.00 for each additional certification; $2.00 for each additional year searched (maximum $50); optional $10 rush fee. The form does not list the $1.00 shipping and handling fee printed on newer applications.
Typical processing: The form says 4 to 6 business days (rush orders within three business days). The office's stillbirth page says 5 to 7 business days. No same-day service.
Form revision: 04/2016
Source: Official government page

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