Illinois Application for Certificate of Birth Resulting in Stillbirth (VR 182)
Official state formStillbirth and pregnancy lossForm VR 182Free downloadLast verified November 10, 2026
Request by a parent for a Certificate of Birth Resulting in Stillbirth after a fetal death of at least 20 completed weeks of gestation in Illinois. It is mailed to the Illinois Department of Public Health, Vital Records.
Who can use this form
- Only a parent named on the fetal death certificate.
- The fetal death must have occurred in Illinois at 20 or more completed weeks of gestation.
What to send with it
- The completed and signed form.
- A photocopy of a non-expired government-issued photo ID. Page 2 of the form lists alternatives.
- A check or money order payable to Illinois Department of Public Health (IDPH).
Where to send it
- Mail to
- IDPH Vital Records 110 West Lawrence Avenue Springfield, IL 62704-2610
- State fee
- $15.00 for the first copy and $2.00 for each additional copy.
- Typical processing
- Allow at least 12 weeks.
- Form revision
- Rev. 08/26
- Source
- Official government page