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Click Here for Participation Agreement Form

Additional instructions for Completing and Submitting an FDRS Participation Agreement are located here.

CA-FDRS Project
Attention: Application Support Desk
MS 5103
P.O. Box 997410
Sacramento, CA 95899-7410

Or send in by fax: Attention CA-FDRS Application Support Desk @ (916) 552-8193


Click Here For Account Maintenance Form

Examples of intended use are:

  • when a user leaves an organization
  • when a user's information needs to be updated
  • when a user's account needs to be disabled
  • Send in by fax: Attention CA-FDRS Application Support Desk @ (916) 552-8193


    Click Here For CA-FDRS Modification Request (FMR) Form

    Use this form to request a change to the CA-Electronic Fetal Death Registration System (CA-FDRS).
    Print, complete, and fax this form to the CA-FDRS Help Desk at (916) 323-2299.