Arizona Administrative Code › Title 9 - HEALTH SERVICES › Chapter 19 - DEPARTMENT OF HEALTH SERVICES - VITAL RECORDS AND STATISTICS › Article 2 - VITAL RECORDS FOR BIRTH › Section R9-19-204 - Requests for Birth Registration from Persons Other than Hospitals or Health Care Providers

Current through Register Vol. 30, No. 28, July 12, 2024
A. To
				request the registration of the birth of an individual not born in a hospital
				whose birth was either not attended by a physician, registered nurse
				practitioner, nurse midwife, or midwife, or was attended by a physician,
				registered nurse practitioner, nurse midwife, or midwife who is not willing or
				not able to comply with requirements in R9-19-203, within seven days after the
				date of the individual's birth, the individual's parent, guardian, or person
				who has custody of the individual shall submit the following to the State
				Registrar or a local registrar or deputy local registrar:
1. The information required in
				R9-19-201(B);
2. If the name of the individual's mother in
				R9-19-201(A)(1)(b)(i)
				is based on a court order establishing maternity, a copy of the court order
				establishing maternity, certified by the issuing entity;
3. If the name of the individual's father in
				R9-19-201(A)(1)(c)(i)
				is based on:
a. A voluntary acknowledgement
				of paternity, a copy of the voluntary acknowledgement of paternity that meets
				the requirements in A.R.S. §
											25-812;
				or
b. An administrative order or a
				court order establishing paternity, a copy of the administrative order or court
				order establishing paternity, certified by the issuing
				entity;
4. A written
				statement attesting to the validity of the submitted information, signed and
				dated by the person submitting the request;
5. One evidentiary document establishing the
				individual's mother's presence in Arizona at the time of the individual's birth
				that:
a. Contains the individual's mother's
				first and last name, the individual's mother's street address or the location
				where the individual's mother was present in Arizona, and the date the
				evidentiary document was created; and
b. Was created no more than 30 days before
				the date of the individual's birth or seven days after the date of the
				individual's birth;
6.
				One evidentiary document supporting the facts of the individual's birth, such
				as:
a. A copy of the part of the individual's
				mother's medical record showing services received by the individual's mother
				during:
i. The three months before the
				individual's birth, or
ii. After
				the individual's birth and before the submission of the request to register the
				individual's birth;
b. A
				copy of the individual's medical record, if seen by a physician, registered
				nurse practitioner, nurse midwife, or midwife before the submission of the
				request to register the individual's birth;
c. The laboratory results of a newborn
				screening test, conducted under A.R.S. §
											36-694;
d. An affidavit from an independent source,
				attesting to personal knowledge of the individual's birth;
e. A certified blessing or baptismal
				certificate for the individual with either a raised seal of the church or
				accompanied by a written statement signed by the church minister or other
				church official; or
f. Another
				document from an independent source containing information that supports the
				facts of the individual's birth; and
7. If the request for registration of the
				individual's birth is submitted by:
a. The
				individual's guardian, a copy of the court order establishing guardianship,
				certified by the issuing court; or
b. A person who has custody of the
				individual, a copy of the court order establishing custody, certified by the
				issuing court.