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District of Columbia · Birth

District of Columbia Request for Fetal Death Certificate

Official state formStillbirth and pregnancy lossFree downloadLast verified November 10, 2026

Use this form to request a certified fetal death certificate for a loss at 20 weeks or more and 350 grams or more, filed after 12/31/2018. It goes to the DC Health Vital Records Division.

Who can use this form

  • A parent named on the record
  • A domestic partner
  • A sibling or grandparent, with proof
  • A guardian of the parent, or a legal representative

What to send with it

  • Completed request form
  • Proof of identity
  • Do not send payment until the office approves the request; it then gives payment options
  • The office's page says to mail or drop off the request

Where to send it

Mail to
Attn: CSCO Unit Vital Records Division District of Columbia Department of Health 2201 Shannon Pl. SE, 1st Floor Washington DC 20020
State fee
$23 per certificate (the form labels this the commemorative fee)
Typical processing
Not provided
Form revision
Revised 9/16/2022
Source
Official government page
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District of Columbia Request for Fetal Death Certificate | District of Columbia Form