LEERS Birth Module

Below you will find LEERS Birth Module Forms, Guides and General Information. We will be routinely adding and updating information on this page for our user community.

LEERS Birth Module User ID Agreement and User Guides

LEERS Birth Module User ID Agreement (fillable)

Facility Worksheet Guidelines

LEERS Birth Module User Guide

Mother's Worksheets

Mother's Cover Letter

Mother's Worksheet - One Page

Mother's Worksheet - Full

Facility Worksheets

Facility Worksheet - One Page

Facility Worksheet - Full

Facility Worksheet - Multiple Birth Attachment

Worksheet for Single Births Below 39 Weeks

Certifier Information

Certifying a Birth Record - One Page Instructions

Birth Certification Process (Summary)

Births Below 39 Weeks Fact Sheet

Paternity Forms

Acknowledgment of Paternity - 2-Party (Hospital)

Acknowledgment of Paternity - 3-Party (Hospital)

Paternity Declaration Form

Hearing Screening Information

Hearing Help and Support

Hearing Glossary of Terms

Other Related Materials

Install Active X Instructions for Printing

CDC Race Codes

SSA Verification Form (9 Weeks)

Continuity of Operations Plan

DHH-IT Security Standards and Procedures