Virginia Surrogate Consent and Report Form for a Contract Not Approved by the Court (VS41)
Official state formParentage and paternityForm VS41Free downloadLast verified November 10, 2026
This packet is used to get a new birth certificate naming the intended parents of a child born in Virginia under a surrogacy contract that no court approved. It is mailed to the Office of Vital Records. The form prints edition 10/2026.
Who can use this form
- The intended parent or parents, the surrogate (gestational mother) and her spouse, if any, and the physician who performed the assisted conception.
- At least one intended parent must be a genetic parent or have legal or contractual custody of the embryo.
- It must be filed within 180 days of the child's birth.
- From December 1, 2026 only the 10/2026 edition is accepted. Older editions must be postmarked by November 30, 2026.
What to send with it
- The completed, signed and notarized VS41.
- A copy of the surrogacy contract signed by all parties.
- A completed and signed VS6B Application for Certification of a Birth Record.
- The intended parents' marriage license, if applicable.
- The applicant's photo ID, or an attorney's Lawyer ID card with a cover letter.
- Genetic tests from an AABB certified laboratory, only if a physician statement cannot be obtained.
Where to send it
- Mail to
- ATTN Surrogacy VDH Office of Vital Records 8701 Park Central Drive, Suite 100 Richmond, Virginia 23227
- State fee
- The form does not state a fee. The office's surrogacy page lists a $10.00 administrative fee to establish the new birth certificate and a $15.00 fee to print the certificate.
- Typical processing
- Not provided
- Form revision
- 10/2026
- Source
- Official government page