Pennsylvania Request to Modify an Adult's Birth Record (Age 18 and Above) (HD002292)
Official state formCorrections and amendmentsForm HD002292Free downloadLast verified November 10, 2026
Asks the Pennsylvania Department of Health to change or correct the birth record of an adult, age 18 or older, including a court-ordered name change or a gender designation. It is not for adoption or parentage changes. Mail it to the Birth Registry in Harrisburg.
Who can use this form
- The person named on the birth record, age 18 or older
- A person holding power of attorney for that person, with the power of attorney attached
- A legal guardian, with the guardianship document attached
- A person asking on behalf of the individual, who must state the reason and relationship
What to send with it
- Completed form, Parts 1 to 6, with Part 6 signed in front of a notary
- Photocopy of a valid government-issued photo ID, or two current documents that show your name and address
- Check or money order payable to "VITAL RECORDS" if you ask for an updated certificate
- Name spelling correction: valid government ID, government-issued marriage certificate, passport or Social Security Numident printout
- Name change, including adding a name: a certified court order
- Gender designation different from sex: a letter from the attending physician providing clinical treatment for gender transition
Where to send it
- Mail to
- Pa. Department of Health Bureau of Health Statistics and Registries ATTN: Birth Registry 555 Walnut St., 6th Floor Harrisburg, PA 17101-1934
- State fee
- No amendment fee is stated. $20.00 for each updated birth certificate, if one is requested. The certificate fee is waived when an incorrect certificate received in the last 45 days is returned, and for members of the U.S. armed forces.
- Typical processing
- Approximately 20 weeks
- Form revision
- REV 04/21
- Source
- Official government page