Illinois Surrogate Parentage Certification: Intended Mother or Co-Parent (VR 810.1)
Official state formParentage and paternityForm VR 810.1Free downloadLast verified November 10, 2026
Certified statement signed by the intended mother or co-parent before the birth of a child carried by a gestational surrogate, so the intended parents are entered on the birth certificate. A photocopy is filed with the Illinois Department of Public Health.
Who can use this form
- The intended mother or co-parent.
- Used when a child is carried by a gestational surrogate under the Gestational Surrogacy Act.
What to send with it
- The statement, signed before two competent adult witnesses who are not parties to the arrangement.
- It must be signed before the birth.
- The original goes to the hospital of planned delivery. A photocopy is filed with the Illinois Department of Public Health.
- It is one of six statements required under the Gestational Surrogacy Act.
Where to send it
- Mail to
- Illinois Department of Public Health 110 West Lawrence Ave. Springfield, Illinois 62704-2610
- State fee
- No charge to file surrogate parentage statements.
- Typical processing
- Not provided
- Form revision
- 08/26
- Source
- Official government page