Stillbirth Certificate Instructions and Application - dhmh maryland 2026

1. Click ‘Get Form’ to open the application in the editor.
2. Begin by entering the date of your application in the designated field (Month/day/year).
3. Indicate the number of copies of certificates you are requesting in the provided space.
4. Fill in your child’s name as it appears on the fetal death certificate, including first, middle, and last names.
5. Provide the date of delivery (Month/day/year) and select your child's sex from the options available.
6. Specify the place of delivery, including hospital name and county or Baltimore City.
7. If known, enter your child’s fetal death certificate number.
8. Complete the parent information section with both mother’s full maiden name and married name, followed by father’s name.
9. Lastly, fill in your mailing address accurately for correspondence regarding your application.
10. Sign where indicated to confirm your request for the certificate.

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