Pennsylvania Request to Modify a Child's Birth Record (Age 1 to Under 7) (HD002289)
Official state formCorrections and amendmentsForm HD002289Free downloadLast verified November 10, 2026
Asks the Pennsylvania Department of Health to change or correct the birth record of a child who is at least 1 but less than 7 years old. It is not for adoption or parentage changes. Mail it to the Birth Registry in Harrisburg.
Who can use this form
- A parent of a child who is at least 1 but less than 7 years old
- A person asking on behalf of the child or parent, who must state the reason and relationship
- Each parent listed on the birth record must sign, unless one has sole custody or is the only surviving parent
What to send with it
- Completed form, Parts 1 to 6
- 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
- Part 6 signed in front of a notary by each parent listed on the birth record
- To change a parent's information: the parent's birth certificate (not a photocopy) or a certified court order of the parent's legal name change
- No documents are needed to change or correct the child's name, date or time of birth, birthplace spelling or sex, or to add a gender designation
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