Pennsylvania Department of Health

Contact Us Regarding Birth & Death Certificates - Vital Records

To contact the Health Department about Birth & Death Certificates please submit the form below.

Before completing this form, please visit our website which may be able to answer your question.

Before you submit your question, the information you are seeking may be available on our user-friendly website, such as:

  • How to obtain certified copies of birth or death certificates (including how to order online or in person)
  • How to correct a birth or death certificates
  • Downloading an application and correction forms
  • Genealogy and adoption registry
  • Where to obtain marriage and divorce certificates

First Name*
 

Last Name*

Email Address*

Street Address 1*

Street Address 2

City*

State*

Zip Code* (i.e. 17000)

Phone Number* (i.e. 7175551212)

What is your inquiry relating to:

Birth Certificate 
Death Certificate 

Name on birth or death record:

Date of birth or death (i.e.12/02/1973):

County of birth or death:

Relationship to individual named on record:

Provide brief explanation of inquiry*:



Fields marked with an asterisk (*) are required.