CDC US Standard Certificate of Death

Fill out
Export or Print
Download your fillable CDC US Standard Certificate of Death in  PDF
CDC US Standard Certificate of Death

In the United States, like in many other countries, a Certificate of Death is a legal form that states the passing of an individual and their death circumstances. The document is of great importance for social science matters, as well as family affairs. Hereunder, we will review the US Standard Certificate of Death peculiarities, legal norms, and requirements and provide guidelines on filling out the certificate form.

Why Use a Death Certificate?

The US has started to collect mortality data back in the 1900s. Someone might argue, but many specialists consider a Death Certificate one of the most important legal documents in human existence. Technically, it is the only legal proof of someone’s passing.

The federal government terminates all social security payments and benefits based on that document, and families use it to manage real estate issues and other inheritance-related questions. These are the most essential yet not exhaustive purposes of a Death Certificate.

As time passed, more personal information was included in the US Standard Death Certificate. The researchers then used this information to make comprehensive reports on how society has changed over the years. For instance, just forty years ago, only two states (Oklahoma and New Hampshire) quit including race and ethnicity on a death certificate. The specialists could trace disease evolution and demographic tendencies based on the gathered mortality data and autopsy analysis.

The primary authority that uses and conducts mortality data analysis is the National Center for Health Statistics (NCHS). Usually, they carry out a big survey every 10-15 years. That is why a 15-year mark is a milestone for legislation regarding death certificates and respective big data analysis.

The most recent legislation revisions came into effect in 2003. Back in the day, the Center for Disease Control and Prevention (CDC) and the Health and Human Services (HHS) have implemented some fundamental changes in data collection. The main idea was to create a certificate form that would comply with the WHO International Classification of Diseases and make the US health reporting globally recognized. Nowadays, twenty-seven states use it.

Even though some local governments began the revision process in 2003, it will take several years to implement the new system in all states. Each state can define its legal peculiarities and the pace of implementing the revised norms. More than 15 years have passed since; therefore, we might be on the verge of another set of amendments.

Other PDF Forms

Are you looking for other PDF forms? Check out the selection following next to see what you could fill in and edit with our tool. Besides that, remember that you can actually upload, fill out, and edit any PDF form at FormsPal.

How to Fill Out the US Certificate of Death

Although the states are entitled to change the form’s details to their liking, the essential parts comply with the official U.S. Standard Death Certificate issued by the NCHS. You may download the certificate form on the agency’s website or use our latest software tools to build any legal form you need. With our software developments, you will have access to an online PDF editor that allows you to fill out the documents online.

Here are some basic recommendations on filling out the US standard death certificate:

  • Read the Instructions

There are three sections to the document. Questions from 1 to 23 are to be filled out by the funeral director. The medical certifier proceeds to fill out questions 24-31 and 32-49. Then, the funeral director finished questions 51-55 of the form.

You will find detailed instructions for each part of the document. We strongly advise you to get acquainted with them before you proceed to fill out the certificate.

  • Enter the Decedent’s Personal Data

The first set of questions is to be filled out by the funeral director. Enter the decedent’s legal name (including AKA, if any), sex, age, SSN, date, and place of birth. If some information is missing, you may contact family members or close friends of the deceased and ask for help.

step 2 enter the decedent’s personal data filling out a cdc us standard certificate of death

  • Provide the Decedent’s Residential Address

Here you must provide the physical address of the place where the deceased last resided. Enter the state, city, postal code, street, building, and apartment number (if applicable).

step 3 provide the decedent’s residential address filling out a cdc us standard certificate of death

  • Indicate Family Status

In this section, you must state if the decedent had ever been part of the US military forces and if he or she had been married. After providing the marital status, insert the surviving spouse’s name (if applicable).

You will also need to provide both parent’s names of the deceased. Please note that you have to fill in the mother’s maiden name (before the first marriage).

step 4 indicate family status filling out a cdc us standard certificate of death

  • Describe the Place and Time of Death

This next section is designed for a medical certifier who pronounces death. The responsible specialist needs to indicate the exact date, time, and location of death. Details are essential to the CDC, so provide as much information as possible.

step 5.1 describe the place and time of death filling out a cdc us standard certificate of death

step 5.2 describe the place and time of death filling out a cdc us standard certificate of death

  • Explain the Cause of Death

Part 2 of the section comprises all significant conditions contributing to death. The designated medical certifier has to insert the causes of death and other matters relevant to mortality statistics. For example, if it is a female, the agency will ask you to state if she was pregnant at the moment of death.

step 6 explain the cause of death filling out a cdc us standard certificate of death

  • Fill in Other Medical Certification Items

If the patient had an injury leading to death, you would need to give a detailed explanation of how the particular wound had occurred. Insert the information in the corresponding boxes.

step 7 fill in other medical certification items filling out a cdc us standard certificate of death

  • Provide the Certifier’s Info

The responsible medical certifier has to provide some personal information too. You need to enter your valid license number and contact information, including name, mailing address, postal code, and current title.

step 8 provide the certifier’s info filling out a cdc us standard certificate of death

  • Fill In Additional Info on the Decedent

Here, the funeral director should fill in any additional information on the deceased, including origin, race, education, occupation, and industry. Choose only one of the suggested options by checking the corresponding box.


Frequently Asked Questions

Can You Make Changes in a Certificate of Death?

Amending a Certificate of Death is a massive problem in the US. Why would anyone need to change the information stated in a death certificate, you may wonder. The thing is, most of the errors occur during the autopsy. Family members tend to have disputes with insurance companies very often, and if they do, they have to prove their right in court. An autopsy has to reveal the accurate diagnosis and cause of death. Sometimes, people even hire independent experts to perform the examination.

But even if you manage to prove a medical mistake, you may get justice for the decedent, as it can take months or years to amend the death certificate (for bureaucratic reasons). Thus, the results have never arrived in time, and the CDC has closed its mortality file. Now all the “pending investigation” cases are permanently recorded as “unknown.”