Family & Safety
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Application for a search of birth record files Blank form
Use this form to request a birth certificate through the State of Illinois Department of Public Health.
Can I use this form?
You can use this form if you need to request a birth certificate.
What do I need first?
You will need the following information to complete this form:
- Your current legal name and your name before your first marriage,
- Your date of birth and place of birth, and
- Your parents' current and former names.
Last revised by staff
August 03, 2021
