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Birth Certificate Request

  1. The City of East Chicago
    Department of Public and Environmental Health
    100 W Chicago Avenue
    East Chicago, IN 46312

  2. Warning

    False application altering, mutilating, or counterfeiting Indiana birth certificates is a criminal offense under I.C. 16-1-10-6.

  3. Disclaimer*

    This form submission is NOT an online payment. For more information concerning online payment please refer to the Vital Records F.A.Q. page. This form only serves those who have been born at St. Catherine's hospital.

  4. Birth records are only issued to the individual named on the record and their parents, guardians, brother, sister, spouse, or children, with a valid ID and birth certificate. (Indiana Law I.C. 16-1-19-1) You must be at least 18 years of age to apply.

  5. Could this birth be recorded under any other name?

  6. We do not accept cash payments or personal checks. Please submit your request along with the exact payment in money order or certified check made payable to the East Chicago Health Department. We also accept credit cards. For mail requests, please include a self address stamped envelope and a Xerox copy of identification of your self, such as a driver's license or state ID.

    We only sell a combo pack (regular size and wallet) for $12.

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