Rhode Island Department of Health - Vital Records · Rhode Island state form
Affidavit of Birth Attendant Attestation VR-36B
Affidavit for a person who attended a home birth to attest to the birth and provide information about the mother, child, and birth circumstances.
- What this form is
- The Affidavit of Birth Attendant Attestation is for a person who attended a home birth, including a birth attended by a non-certified health provider. The affiant provides details about the mother, infant, birth date and address, their relationship to the mother, and their contact information. The form includes a declaration that the information is true and correct and a notary section. The document says to keep such affidavits on file.
- Who needs it
- A person who attended a home birth may complete this affidavit, particularly when the birth was attended by a non-certified health provider.
- Why it needs a notary
- The affidavit must be signed before a notary. You can complete this step online with a commissioned online notary.
- How to submit it
- The document says to keep such affidavits on file. It identifies the Center for Vital Records at 6 Harrington Road, Cranston, RI 02920.
Questions
Who completes the Birth Attendant Attestation Affidavit?
The person who attended the home birth completes the affidavit. The form requests information about the mother, infant, birth date and address, and the affiant’s relationship and contact details.
Does the Birth Attendant Attestation Affidavit need to be notarized?
Yes. The form includes a section stating that the affiant subscribed and swore to the affidavit before a notary. You can complete notarization online with a commissioned online notary.
What does the affidavit attest to?
The affiant states from personal knowledge that the mother was pregnant and that they delivered a live-born or stillborn infant on the date entered on the form.