Birth Certificates in Texas - Birth Worksheet Packet - Submission and Required Proofs

Sep 14, 2026

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Birth Certificates in Texas outlines the evidence needed to register a child’s birth, including proof of pregnancy via a notarized medical affidavit, proof the infant was born alive using medical records or a provider letter, proof the birth occurred in the correct registration district (including residency evidence for home births), and proof of the stated birth date from licensed institutions. It also explains when affidavits can be used in special circumstances and how to complete the Birth Worksheetfor Child's Birth Certificate for reporting through TxEVER, emphasizing accurate, legally reliable information.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages18

Reading Time45 min

AccessFree to download

You Have to Prove:

Use of Affidavits

Birth Worksheetfor Child's Birth Certificate

# Birth Certificates in Texas ## You Have to Prove: 1.Your pregnancy:This has to be a notarized affidavit from a medicalprovider. 2.That the infant was born alive:A medical record for your baby or a letterfrom a provider. 3.That the infant was born in the registration district:If your baby wasborn at home,you just need proof of residency for this(utility bill,rentreceipt etc.). 4.That the infant was born on the date stated:A medical record from alicensed institution. ## Use of Affidavits For one of the above cases you can use an affidavit.Let's say you didn't take yourbaby to a doctor on the day he or she was born.In that case,you may want to ask afriend or family member to sign an affidavit stating that the infant was in fact bornon that day at that time at your residence.You will have to get that affidavitnotarized.Most banks will notarize free of charge,but places like UPS may offernotary services for a small fee,too.Be as specific as possible on the affidavit(evento the point of being redundant)to avoid having to do it over.For example,theaffidavit shouldn't just list the date and time the baby was born but also the namesand addresses of the parent and the birth place of the baby. ## Birth Worksheetfor Child's Birth Certificate This birth certificate worksheet is a tool to help your facility collect the necessary information forreporting births in TxEVER,the Texas Electronic Vital Events Registrar.Medical personnel shouldcomplete this worksheet.The information you report in TxEVER is used to create a child's birth certificate.Ensure the information you report is correct so that an accurate birth certificate is created.The birthcertificate is a legal document that the child will use throughout their life to prove their identity,birthplace,and parentage.The State of Texas safeguards against the unauthorized release of identifyinginformation from birth certificates to protect the confidentiality of parents and their child. | Newborn
蹄望与圆
Newborn Information | | | | | | --- | --- | --- | --- | --- | | Record Type:
□ Born at this facility
□ Born en-route to facility
□ Foundling/Safe Haven
□ Home birth-Intended
□ Home birth-Intent unknown
□ Home birth-Unintended
□ Surrogacy-1 Parent
□ Surrogacy-2 Parent | Plurality:
II Single
□ Twins
IITriplets
π Quadruplets
U Quintuplets
11Sextuplets
□ Septuplets
J Eight
□ Nine
u Ten
1Unknown | Birth Order:
□ First
.I Second
」Third
.I Fourth
Fifth
jSixth
Seventh
Eighth
Ninth
Tenth
Conjoined | Is Child Unnamed?
□ Yes
□ No | | | First Name: | Middle Name: | Last Name: | | Suffix; | | Date of Birth;
/__
_/. | Time of Birth:
--:-
□ AM □ PM | Sex;
□ Female
□ Male
□ Unknown/Not yet
Determined | Infant's Medical
Record Number: | | | SSN Information | | | | | | Parents Authorize Release of Information to Social Security Administration to Issue this Child a SSN:
□ Yes
□ No
□ Unknown | | | | | | Mother's Information | | | | | | Title Preference:
□ Mother
□ Father
□ Parent | Legal First Name: | Legal Middle Name: | Legal Last Name: | | | Legal Suffix; | Medical Record Number: | | | | VS-109(rev.07/21) Birth Worksheetfor Child's Birth Certificate | Facility Information &Place of Birth | | | | | | --- | --- | --- | --- | --- | | Name:
□ Facility Name:
□ Other | Facility Name
Other(Specify): | | Type:
□ Clinic/Doctor's Office
□ Home Birth Intended
□ Home Birth Intent Unknown
□ Home Birth Unintended
□ Hospital
□ Licensed Birthing Center
□ Other
□ Unknown | Type Other Specify; | | Address: | | Apt: | State: | County: | | Local: | City/Town: | | Zip: | Zip Ext: | | Mother
一
Mother's N

FAQs

What proof is required for pregnancy when registering a Texas birth certificate?

A notarized affidavit from a medical provider is required to prove the pregnancy.

How can you prove the infant was born alive or at the registration district?

Use the baby’s medical record or a provider letter for born-alive proof. For being born in the registration district, provide residency proof for home births (such as a utility bill or rent receipt).

What is the Birth Worksheet for and what system is it used with?

The worksheet collects required information for reporting births in TxEVER, the Texas Electronic Vital Events Registrar. Medical personnel complete it so the data creates an accurate birth certificate.

Sep 14, 2026

Upload by Xiajie