
Nebraska Department of Health and Human ServicesApplication for Certificate of Birth Resulting in Stillbirth Only the parent(s) of a stillborn (fetal death) may obtain a certified Certificate of Birth.
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How to fill out the NE HHS-89 online
The NE HHS-89 form, also known as the Application for Certificate of Birth Resulting in Stillbirth, is designed for parents seeking a certified birth certificate for their stillborn child. This guide will provide clear, step-by-step instructions to ensure a smooth completion of the form.
Follow the steps to complete the NE HHS-89 form online.
- Press the ‘Get Form’ button to obtain the NE HHS-89 form and open it in your browser or document editor.
- Begin by entering the full name of the child in the designated field, ensuring accuracy and clarity.
- Next, input the month, day, and year of the stillbirth in the appropriate section.
- Indicate the city or town where the stillbirth occurred, followed by the county in the specified fields.
- Fill in the full name of the father or parent, followed by the mother or parent's name as recorded at birth.
- State the purpose for which the birth record will be used in the corresponding section.
- Clarify your relationship to the individual listed on the record in the designated area.
- Sign the form in the signature field, ensuring that it is your name as the requestor.
- Provide your street address, city, state, and zip code in the fields designated for your contact information.
- Enter your telephone number and email address to allow for easy communication regarding the request.
- Include today's date in the date field at the bottom of the form.
- If mailing the completed request, make sure to enclose a photocopy of your photo identification, as outlined in the instructions.
- For office use only: Acknowledge that the payment methods such as checks or cash are to be filled out appropriately in the office section.
- Once all fields are completed, save the changes, and you will have the option to download, print, or share the completed form.
Complete your NE HHS-89 form online today to request your certified Certificate of Birth Resulting in Stillbirth.
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What does Nebraska Dhhs do?
The agency provides health and human services for both families and regular patients. DHHS is Nebraska's largest agency and is responsible for nearly one-third of the state's government, both in employees and budget. DHHS consists of five divisions, seven facilities, and eight operational areas.
How do I file a complaint with Dhhs Nebraska?
Call the complaint intake line at (402) 471-0316 Hours: M-F 8 a.m.- 5 p.m. CST. Fax the complaint to (402) 742-2389.
How do I contact Dhhs Nebraska?
Contact DHHS Main Switchboard: (402) 471-3121. Physical Address: 301 Centennial Mall South, Lincoln, Nebraska GET MAP. Mailing Address: Nebraska Department of Health & Human Services P.O. Box 95026, Lincoln, Nebraska 68509-5026 Assistance Programs: Website Feedback:
How do I check my Nebraska Medicaid status?
Call the Medicaid claims customer service at (877) 255-3092 or (402) 471-9128. Provide the Medicaid claim number (if you have it) or your 11-digit Medicaid provider number, the client's 11-digit Medicaid ID number and the claim date of service.
What is Nebraska Medicaid called?
Nebraska's Medicaid managed care program, Heritage Health , combines Nebraska Medicaid's physical health, behavioral health, and pharmacy programs into a single comprehensive and coordinated program for the state's Medicaid and Children's Health Insurance Program (CHIP) enrollees.
What is the phone number for dhhs medicaid near omaha ne?
Phone lines are open from 8:00 a.m. to 5:00 p.m. Monday through Friday. (855) 632-7633. In Lincoln: (402) 473-7000. In Omaha: (402) 595-1178.
How do I contact Dhhs Medicaid in Nebraska?
Apply for Medicaid Phone lines are open from 8:00 a.m. to 5:00 p.m. Monday through Friday. (855) 632-7633. In Lincoln: (402) 473-7000. In Omaha: (402) 595-1178.
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