The Online Resource for Massachusetts Poverty Law Advocates

Revised Office of Medicaid Form for Massachusetts birth certificate


The Office of Medicaid has revised the form to be used to request a record of Massachusetts birth from the Vital Statistics Office. The birth record will be sent back to the Office of Medicaid not the applicant. An applicant born in Mass. who needs a copy of the birth certificates can obtain it at no charge from the Vital Stats. Office but not by using this form.

To save files, right click and choose 'Save Target As' or 'Save Link As'
File Attachment: 
PDF icon mass_birth_record_request.pdf78.8 KB

Limit Offer