Guide to Referring Birth Certificate (BC) Requests to HAP

Important Information

Is your site already served by a HAP Virtual Clinic?

1. HAP pro vides birth certificates for those who attend HAP’s virtual clinics.
   • Virtual clinics are held for residents in SELF and Bethesda residential sites
   • Virtual clinics are held for residents of a number of family shelters including Woodstock, House of Passage, Eliza Shirley, Red Shield and Families Forward.
2. Case managers at any location served by virtual clinics should not refer anyone directly to HAP for birth certificates without first getting authorization from HAP staff.

Case Managers are expected to submit referral packets that are complete and legible.  The packet will be returned to you and delay the processing if: all required forms are not complete and legible OR a virtual clinic is scheduled for your shelter.

Case Manager Referral Process

Referral Packets consist of a variety of forms (NONE should be signed by the Case Manager):

1. HAP Representation Agreement – client must sign
2. HAP Release of Information –client must sign
   • If the participant is requesting BC for their child(ren), a separate child release must be completed for each child – click here for the form – and client must sign each release
3. Birth Certificate Information Form – must be completed for each request.
4. Additional Specific Birth Certificate Application Documents to include in packet depend on the state where your client was born
   • Different states have different requirements with regard to signatures, other documents that are needed and whether a notarized statement is required.
     • Click here to see what forms you would need depending on what state the applicant was born in.
   • Common States for Birth Certificate Requests
     • Pennsylvania: PA Birth Certificate Application with fee waiver for anyone experiencing homelessness
       • Client must sign part 5 of the PA application (only part 5)
       • A separate application must be signed for each request. (Ex. Mom plus 3 children requires 4 signed applications)
     • NYC: Attorney Protocol and copy of ID or a photo
     • Maryland and Puerto Rico: notarized affidavit required. HAP has two notaries on staff.  Please call us to make an appointment at 215-523-9595.

Submitting the Referral Packet and Next Steps

1. Scan packet and send it to [email protected]
2. HAP will need at least two weeks to open cases, run conflicts, and process application
3. Depending on the State, it could take 4-12 weeks for vital records to process the birth certificate if there are no issues
4. It is critical that you provide HAP with updated client contact information if client moves on for any reason.

Questions: please call HAP at 215-523-9595 or email us at [email protected].

We appreciate your support!