Virginia Application for Certification of Birth Resulting in Stillbirth (VS6)
Official state formStillbirth and pregnancy lossForm VS6Free downloadLast verified November 10, 2026
A parent uses this form to ask the Virginia Office of Vital Records for a Certificate of Birth Resulting in Stillbirth when the pregnancy lasted 20 weeks or more. It is mailed to the office in Richmond.
Who can use this form
- Either parent listed on the fetal death report.
- The form offers only mother or father as the relationship.
- The gestational period must be 20 weeks or more.
- The certificate can only be issued to the parents.
What to send with it
- The completed and signed application.
- An enlarged, readable and clear photocopy of the requester's identification.
- One document from the primary identification list or two from the secondary list printed on the back of the form.
- A name for the stillborn child is optional.
Where to send it
- Mail to
- Office of Vital Records P. O. Box 1000 Richmond, VA 23218-1000
- State fee
- No cost. The form says the State Registrar issues the Certificate of Birth Resulting in Stillbirth at no cost.
- Typical processing
- Not provided
- Form revision
- 07/22
- Source
- Official government page