A birth certificate for an unassisted birth

For Pima County Arizona

Requests Submitted Within Seven (7) Days After Birth - To request the registration of a birth record for a child not born in a hospital and whose birth was not attended by a health care provider, the child's parent, guardian or a person who has custody of the child shall submit the following to the County Vital Records Office in the county where the birth occurred to request registration of a birth record:

  1. A completed Certificate of Live Birth Worksheet signed by the person that attended the birth and the informant;

  2. If applicable, a certified copy of a maternity order that identifies the mother to be listed on the birth record;

  3. If applicable, a completed, signed Acknowledgment of Paternity form that identifies the father to be listed on the birth record or a certified copy of an administrative order or court order establishing paternity;

  4. One (1) evidentiary document establishing the mother's presence in Arizona at the time of the child's birth that:

    1. Contains the mother's first and last name, address or location where the mother was present in Arizona, and the date the evidentiary document was created; and

    2. The date the evidentiary document was created shall not be more than 30 days before the date of the child's birth or more than seven (7) days after the date of the child's birth.
      Examples: a utility bill, bank statement, rental agreement.

  5. One (1) evidentiary document that supports the fact of the child's birth such as:

    1. A copy of the mother's medical record that shows services received by the mother during

      1. the three (3) months before the child's birth

      2. After the child's birth and before submission of the request to register the child's birth record.

    2. A copy of the child's medical record, if seen by a health care provider before the submission of the request to register a birth record;

    3. The laboratory results of a newborn screening test, conducted under A.R.S. §36-694;

    4. An affidavit from an independent source, attesting to personal knowledge of the child's birth;

    5. A certified blessing or baptismal certificate for a child with a raised seal of the church or accompanied by a written statement signed by the church minister or other church official; or

    6. Another document from an independent source containing information that supports the facts of the child's birth; and

      *a chiropractor can sign a confirmation before or after birth*

  6. If the request for registration of the child's birth is submitted by:

    1. The child's guardian, a certified copy of the court order establishing guardianship,or

    2. A person who has custody of the individual, a certified copy of the court order establishing custody.

Note: If the request to register a birth record is submitted by mail, the mailing envelope must be postmarked within seven (7) days of the birth.

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Requests Submitted More Than Seven (7) Days But Less Than One (1) Year After Birth If the birth was not attended by a health care provider, a child's parent, guardian or a person who has custody of the child may submit a request to register a birth record more than seven (7) days but less than one (1) year after a child's birth. The following shall be submitted to the County Vital Records Office in the county where the birth occurred of a birth record:

  1. A completed Certificate of Live Birth Worksheet signed by the person that attended the birth and the informant;

  2. If applicable, a certified copy of a maternity order that identifies the mother to be listed on the birth record;

  3. If applicable, a completed, signed Acknowledgment of Paternity form that identifies the father to be listed on the birth record or a certified copy of an administrative order or court order establishing paternity;

  4. One (1) evidentiary document establishing the mother's presence in Arizona at the time of the child's birth that:

    1. Contains the mother's first and last name, address or location where the mother was present in Arizona, and the date the evidentiary document was created; and

    2. The date the evidentiary document was created shall not be more than 30 days before the date of the child's birth or more 30 days after the date of the child's birth.

      1. Examples: a utility bill, bank statement, rental agreement.

  5. One (1) evidentiary document that supports the fact of the child's birth such as:

    1. A copy of the mother's medical record that shows services received by the mother during the three (3) months before the child's birth or six (6) weeks after the child's birth;

    2. A copy of the child's medical record, if seen by a health care provider less than six (6) weeks after the child's birth;

    3. The laboratory results of a newborn screening test, conducted under A.R.S. §36-694;

    4. An affidavit from an independent source, attesting to personal knowledge of the child's birth;

    5. A certified blessing or baptismal certificate for child with a raised seal of the church or accompanied by a written statement signed by the church minister or other church official; or

    6. Another document from an independent source containing information that supports the facts of the child's birth; and

  6. If the request for registration of the child's birth is submitted by:

    1. The child's guardian, a certified copy of the court order establishing guardianship, or

    2. A person who has custody of the individual, a certified copy of the court order establishing custody.

NOTE: If a request to register a birth record is not submitted to a Vital Records Office before the child's first birthday, the parent, guardian or a person who has custody of the child shall apply for a Delayed Birth Certificate.

(Pima County Arizona Vital Records)

Health Department Office of Vital Records pima county

3950 S. Country Club Road, Suite 100
Tucson, AZ 85714
(520) 724-7932