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Early pregnancy loss recognition certificate

We offer our condolences for your loss.

We are not able to register the birth but you do have the right to commemorate your family’s loss—if your baby was delivered before 20 weeks gestation or if weeks are unknown, weighed less than 400g.

To recognise your loss, you can apply for a free recognition certificate—there are 2 designs for you to choose from. You cannot use the certificate for official purposes.

If you would like an early pregnancy loss recognition certificate fill in the application form online, download and print the completed application form, sign it, have your treating medical practitioner or midwife sign the declaration, and then submit it by post or in person.

If your delivery took place after 20 weeks, you will need to register the birth.

Rules for applying

To apply for an early loss of pregnancy recognition certificate:

  • your delivery must have taken place in Queensland, before 20 weeks gestation
  • or if weeks are unknown your baby weighed less than 400g
  • your treating medical practitioner or midwife must be able to sign the declaration on the application form.

How to apply

To apply for your free recognition certificate, you need to:

  1. Read and understand the rules.
  2. Complete, download, print and sign the application form.
  3. Get your treating medical practitioner or midwife to sign the health professional’s declaration.
  4. Submit your application form to us by post or at the counter.

By post

Post your completed application form to:

Registry of Births, Deaths and Marriages
PO Box 15188
City East Qld 4002.

In person

Visit the Brisbane registry counter at 110 George Street, Brisbane with your completed application form.

Fill in the application form

For more information


Email, online enquiries are replied to within 2 business days.

By phone


(Phone lines open Monday–Friday, 8.30am–4.30pm)

Local call* 13 QGOV (13 74 68)
International +61 7 3405 0985 (+10 hours UTC)

*Costs may be higher from mobile phones and interstate.

(Monday–Friday, 8.30am–4.30pm).

Start the application form

Fill in, download and print the early pregnancy loss recognition certificate application form.

Last updated
1 August 2016

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