For fax or email requests:

Download the form here.

You can fill the form out from your computer or print the form and fill in the information.

Forms can be faxed or emailed to 812-882-5625 or knoxcountyinhealth@print.epsonconnect.com

Do not send your credit/debit card information

Once the information has been verified, we will contact you for payment.

There is a $1.00 fee for all credit/debit card orders under $33.00 and 3.0% fee for orders over $33.00

For Requests by Mail:

Download the form here.

Mail your completed form to us at:

Attn: Vital Records

305 South 5th Street

Vincennes, Indiana 47591

Please include a check or money order for $15.00 or indicate you want to use a credit/debit card.

If you cannot print the form please provide the following information with your request:

• Full name at birth
• Place of birth – City/County
• Date of birth
• Father’s full name
• Mother’s full name – including maiden
• Purpose for which this record is to be used
• Your relationship to the person whose birth record you are requesting
• Include a clear photocopy of your photo ID (driver’s license, or any photo ID that has both a picture and your birth date.
• Sign the request
• Include your phone number, address, and the date you’re requested it.
• Please include your check or money order for $15.00 or indicate you want to use a credit/debit card.
• Please send a self-addressed stamped envelope.

There is a trusted website – VitalChek.

After processing your order you will need to print your forms.

One of the forms will have a rectangular box for you to lay your photo ID down on and scan it.

Then, you will fax or email that form to us as a request for your birth certificate.

Our fax number is 812-882-5625, email knoxcountyhealth@hpeprint.com.

On VitalChek, you will pay with a credit/debit card. It is possible to get your certificate faster by choosing to have it sent by UPS.

I want to make you aware that Vitalchek has set the shipping default to automatically add the UPS charges. You may change this fee to be shipped by US Postal Service and eliminate that extra charge.