Vermont Consent to Parentage from Assisted Reproduction
Official state formParentage and paternityFree downloadLast verified November 10, 2026
Each intended parent signs this record to consent to assisted reproduction so they can be named as parents on the child's birth certificate. It goes to the Vital Records Office in Waterbury.
Who can use this form
- Each intended parent.
- Signed with a witness. No notary is needed.
What to send with it
- The completed, signed form.
Where to send it
- Mail to
- Vital Records Office Vermont Department of Health 280 State Drive Waterbury, VT 05671-8370
- State fee
- Not provided
- Typical processing
- Not provided
- Form revision
- February 2026
- Source
- Official government page