Commemorative Certificate of Non-Viable Birth
On April 18, 2018, Governor Ricketts signed LB 1040 into law in Nebraska.
Instructions for requesting a Commemorative Certificate of Nonviable Birth
A health care practitioner/health care facility will advise a patient who experiences a nonviable birth that the patient may request a commemorative certificate and, upon request of the patient, shall provide a letter verifying the nonviable birth to the patient.
If a health care practitioner/health care facility letter is to be used then the following information must be provided in the letter:
- Full name of baby (if named)
- Month, day and year of loss
- City, town and county of loss
- Mother's full current legal name (first, middle last, suffix)
- Father's full current legal name (first, middle last, suffix) (if known)
In lieu of the letter the health care practitioner or his/her designee may provide the patient with the completed Nonviable Birth Worksheet.
The patient must submit either the letter or the completed Nonviable Birth Worksheet together with a Nonviable Birth Application and a fee of $19.00 per certificate, to the Department of Vital Records located at 301 Centennial Mall South, Lincoln, NE 68509 in person or by mail. The department shall issue a commemorative certificate within 60 days of receipt of the completed letter/worksheet application and fee.
This commemorative certificate is not proof of a live birth.
Pursuant to Nebraska Statute 71-607: The following statement shall appear on the front of the commemorative certificate: This commemorative certificate is not proof of a live birth. The department shall not register the birth associated with a commemorative certificate issued under this section or use it to calculate live birth statistics. The commemorative certificate is commemorative in nature and has no legal effect. A commemorative certificate issued under this section shall not be used to establish, bring, or support a civil cause of action seeking damages against any person or entity for bodily injury, personal injury, or wrongful death for a nonviable birth.
Documents
Nonviable Birth Worksheet
Nonviable Birth Application
Definitions
Nonviable birth: An unintentional, spontaneous fetal demise occurring prior to the twentieth week of gestation during pregnancy that has been verified by a health practitioner.
Health Practitioner: A health care practitioner licensed pursuant to the Uniform Credentialing Act who attends or diagnoses a nonviable birth or a health care facility pursuant to the Health Care Facility Licensure Act at which a nonviable birth occurs.