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Department of Human Services
Out-of-State Birth Certificate Requests
Verify Citizenship for FPEP Clients Born Outside of Oregon
As a result of the federal Deficit Reduction Act of 2005, all clients must provide citizenship verification documents to be eligible for FPEP (Family Planning Expansion Project), Oregon's family planning Medicaid waiver.

FPEP applicants born in Oregon may request an electronic search for their birth record by submitting a Birth Information Form to their local clinic. Click here for more information about Oregon Birth Record Requests.

As of March 1, 2008, the State Family Planning Program will order birth certificates from other states to help non-Oregon born FPEP applicants document U.S. citizenship. The materials and links below explain this process.

On this page:


Links to State Birth Certificate Request Forms
Click the links below to download state-specific forms.
State Forms
Alabama (pdf)
Alaska (pdf)
Arizona
Arkansas (pdf)
California
Colorado (pdf)
Connecticut
Delaware (pdf)
Florida (pdf)
Georgia (pdf)
Hawaii (pdf)
Idaho (pdf)
Illinois (pdf)
Indiana (pdf)
Iowa (pdf)
Kansas (pdf)
Kentucky (pdf)
Louisiana (pdf)
Maine
Maryland (pdf)
Massachusetts
Michigan (pdf)
Minnesota (pdf)
Mississippi (pdf)
Missouri (pdf)
Montana (pdf)
Nebraska (pdf)
Nevada (pdf)
New Hampshire (pdf)
New Jersey (pdf)
New Mexico (pdf)
New York City (pdf)
New York State (pdf)
North Carolina (pdf)
North Dakota (pdf)
Ohio (pdf)
Oklahoma (pdf)
Pennsylvania (pdf)
Rhode Island (pdf)
South Carolina
South Dakota
Tennessee (pdf)
Texas (pdf)
Utah (pdf)
Vermont (pdf)
Virginia
Washington (pdf)
Washington DC
West Virginia (pdf)
Wisconsin (pdf)
Wyoming
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Links to California County Forms
Click the links below to download county-specific request forms.
California Counties - Please check links below for county forms. Then search California State Website
Alameda (pdf)
Alpine
Call county at
530-694-2286
to request forms via fax
Amador (State site)
Butte (pdf)
Calaveras (pdf)
Colusa (doc)
Contra Costa
Del Norte (State site)
El Dorado (pdf)
Fresno (pdf)
Glenn
Humboldt (pdf)
Imperial (State site)
Inyo (pdf)
Kern (pdf)
Kings (pdf)
Lake (pdf)
Lassen (pdf)
Los Angeles (pdf)
Madera (pdf)
Marin (pdf)
Mariposa (pdf)
Mendocino (pdf)
Merced (pdf)
Modoc
Call county at
530-223-6205
to request forms via fax
Mono (pdf)
Monterey (pdf)
Napa (pdf)
Nevada
Orange
Placer (pdf)
Plumas (pdf)
Riverside (pdf)
Sacramento (pdf)
San Benito (pdf)
San Bernardino (pdf)
San Diego (pdf)
San Francisco (State site)
San Joaquin (pdf)
San Luis Obispo (pdf)
San Mateo (pdf)
Santa Barbara (pdf)
Santa Clara (pdf)
Santa Cruz (pdf)
Shasta (pdf)
Sierra
Call county at
530-289-3295
to request forms via fax
Siskiyou (pdf)
Solano (pdf)
Sonoma (pdf)
Stanislaus
Sutter (pdf)
Tehama (pdf)
Trinity (pdf)
Tulare
Tuolumne
Ventura (pdf)
Yolo (pdf)
Yuba (pdf)
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Related Links

Provider Materials
Provider Trainings
 
Page updated: August 26, 2008

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