FPEP Out-of-State Birth Certificate Request Flow Chart
Start Was client Clinic reviews birth certificate If all requirements met, clinic
Client requests birth No request requirements for client’s downloads state-specific
born in Oregon?
certificate. state of birth using matrix posted on request form using link
state website. provided in matrix.
Clinic enters birth
certificate request Oregon Birth IF client doesn’t have FPEP # yet and will not Client completes state-specific
information in FPEP Information Form be using an FPEP one-time only exception request form and top portion of
eligibility database. is completed. that day, write ‘pending’ in space provided for Authorization to Release Birth
Stop FPEP # on the Authorization to Release Birth Certificate Form. Client also
Certificate Form before sending to Oregon provides any necessary
Family Planning Program. documents (e.g. photo ID).
Clinic gathers multiple client Clinic enters client’s birth Clinic provides notary sworn Clinic collects state-specific
requests (originals) and mails certificate request information statement if required. (On request form and authorization
to Oregon Family Planning into log in case follow-up is state-specific request form form from client. Clinic makes
Program in self-addressed needed. and in space provided in box photocopy of ID if necessary.
stamped envelopes once per on Authorization form.)
week at minimum.
Oregon Family Planning Oregon Family Planning Oregon Family Planning Clinic keeps birth certificate
Program completes lower Program mails documents and Program mails original birth in client’s chart/medical
portion of authorization form application fee to state Vital certificates to clinic. Clinic record and releases birth
and mailing address portion of Records Office. Oregon Family updates citizenship verification certificate to client only if
state-specific request form. Planning Program receives documentation for client in client requests copy of
certified birth certificate. eligibility database. medical records.