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H1N1 VACCINE POLL 

Do you live in Cochise County?

What is your zip code?

 

Will anyone in your family
receive the H1N1 shot?


If yes, please answer the
questions below.


Number of children:

ages 10 - 18yrs.

ages 6 months - 10yrs.

Number of Adults:

ages 18 - 64yrs.

ages 65yrs. and over.

Director
Vaira Harik

 

Contact Us

health@cochise.az.gov
 

Toll Free
1-800-423-7271

 

Keep your sick kids home from school. Visit www.cdc.gov/h1n1 for more information.

 

Benson  
126 W. 5th Street 
Benson, AZ 85602

(520) 586-8200

 

Bisbee 

(Main Office)
1415 Melody Lane Bldg. A 
Bisbee, AZ 85603
(520) 432-9400


Douglas  
515 7th Street
Douglas, AZ 85607
(520) 805-5600

 

Sierra Vista 

4115 E. Foothills Drive
Sierra Vista, AZ 85635
(520) 803-3900


Willcox 
450 S. Haskell Avenue
Willcox, AZ 85643
(520) 384-7100

Health Department

Home Birth Registrations & Certificates 

 

Locations:        4115 E. Foothills Drive                                   1415 Melody Lane, Bldg. A
                        Sierra Vista, AZ 85635                                   Bisbee, AZ 85603
                        Phone: 520-803-3925                                     Phone: 520-432-9400

Email:              vitalrecords@cochise.az.gov

Office Hours:    Monday – Friday from 8:00am – 4:00pm.

 

What Is A Home Birth - Home birth is defined as: the child and placenta are born away from a hospital or birthing facility, and not en route to a hospital or birthing facility. Note: If a child or placenta is delivered en route to or at a hospital or birthing facility, the hospital or birthing facility is required to register the birth as a hospital birth not a home birth.

 

When a child is born at home, who may register the child’s birth?  The child’s father, mother, other family member, or a person present during or immediately after the birth may register the birth if they are at least 18 years old A.R.S. 36-333.  If the child is being registered within 7 days of the birth (if registered by mail, then, postmarked within 7 days of the birth,), the following must be submitted:

1. Certificate of Live Birth form must be completed and signed by the informant and attendant and must be forwarded to the County or State Vital Records office. 

2. If the parents are not married, an Acknowledgement of Paternity or Court-Ordered Paternity (certified copy) must be submitted before the father can be added to the birth certificate.

 

Requirements for Late Registration (More than 7 days but less than 1 year) - If a child’s birth is being registered more than 7 days but less than 1 year after birth, a parent may register their child’s birth by submitting the following documents R9-19-202:

1. The mother, father, family member, physician, nurse or midwife registering the birth must provide a completed Certificate of Live Birth form signed by informant and attendant.

2. Document proving the mother was present in Arizona at the time of birth.

      a. Examples include:

         i. Medical record, utility bill, public assistance document, etc.       

           

           • The document must show the month and year in which the child was born with the mother's name and address.

 

            • The document must show the date it was established.

3. Document proving the child was present in Arizona at the time of birth.

       a. Examples include:

          i. Medical record, church record, public assistance document, etc.

              • The document must show the month and year in which the child was born with the mother's name and address.

              • The document must show the date it was established.

4. If the parent's are not married, an Acknowledgement of Paternity or Court-Ordered Paternity must be submitted before the father can be added to the birth certificate.

 

Where Do I Get the Forms I Need to Register a Home Birth? 

1. To obtain a Certificate of Live Birth form and instructions packet, call 602-364-2429.

2. To obtain an Acknowledgement of Paternity form Click Here 

 

Requirements to Register a Birth of a Person Over 1 Year Old - If a home birth has not been registered more than 1 year after birth, you must apply for a “delayed birth” certificate.  See the Arizona Department Of Health Services - Office of Vital Records Delayed Birth web page for further instructions. 

 

Fees & Payments - The charge for a certified copy of a birth certificate is $10.00, payable by money order, cash, or debit card (in office payments only).

 

 

How To Apply - Certified copies of birth certificates can be requested by visiting one of our offices, or by sending a request with all required documentation and payment via mail.  We do not accept requests via fax or email. The documentation needed to obtain a certified copy of a birth certificate is:

 

  • Application Request Form – Click Here to download the form or it is also available at our local office. 
  • A government issued picture ID, i.e. a valid driver's license, state ID etc. with applicant's signature. 
  • Click Here for Birth Certificate Eligibility Information 
  • If not for self, documentation showing your relationship to the person the requested certificate is for.The Office of Vital Records is able to guide applicants through this process.

We recommend calling us at (520) 803-3925 with any questions, before bringing/sending us your paperwork.

Please note if the child is over one year of age a Delayed Birth Certificate must be filed by the informant with the Arizona State Office of Vital Records instead.

 

To get more information from the Arizona Department of Health Service's Office of Vital Records please visit http://www.azdhs.gov/vitalrcd/index.htm, reach them by phone at (888) 816-5907 or (602) 364-1300, or by mail at Arizona Department of Health Services, Office of Vital Records, 1818 West Adams, Phoenix, AZ 85007.