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Application for a search of birth record files Blank form
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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.

Learn more about getting a copy of your 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.

This will take you to another website.

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Last revised by staff
August 03, 2021

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