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APPLICATION FOR A CERTIFIED COPY MICHIGAN STILLBIRTH RECORD Michigan Department of Health and Human ServicesPART 1 APPLICANT INFORMATION (PERSON FILLING OUT THIS FORM) Applicants First Name ___ Middle
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How to fill out michigan certificate of stillbirth

01
Obtain the Michigan Certificate of Stillbirth form from the Michigan Department of Health and Human Services website or your healthcare provider.
02
Fill out the section for the decedent's information, including the stillborn child's name, date of birth, and place of birth.
03
Complete the parent's information section, providing details like names, addresses, and contact information.
04
Have the attending physician or midwife complete their section, providing the cause of stillbirth and other medical details.
05
Review the form for accuracy and completeness before submitting.
06
Submit the completed certificate to your local county clerk's office to officially record the stillbirth.

Who needs michigan certificate of stillbirth?

01
Parents who have experienced a stillbirth in Michigan.
02
Legal representatives or guardians of the deceased stillborn child.
03
Healthcare professionals involved in the care of the mother or child may also need the certificate for record-keeping purposes.
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The Michigan certificate of stillbirth is an official document that is issued to record the stillbirth of a fetus after 20 weeks of gestation. It serves as a legal record of the event.
The certificate of stillbirth must be filed by the attending physician, midwife, or healthcare provider who was present at the time of the stillbirth.
To fill out the Michigan certificate of stillbirth, the responsible healthcare provider must complete the required fields, which include details about the deceased fetus, the parents' information, and the circumstances surrounding the stillbirth.
The purpose of the Michigan certificate of stillbirth is to provide legal documentation of the stillbirth, which can be important for various reasons including obtaining burial permits, cemetery arrangements, and statistical tracking.
The information that must be reported includes the date of stillbirth, gestational age, sex of the fetus, causes of stillbirth if known, and the names and addresses of the parents.
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