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Death Certificate at for doctors Form: What You Should Know

DOH-308 Registration of Deaths Death Certificate — Application for Correction of Record — Request for Correction of Death Certificate (DOH-279-001, 2/5/14) For corrections, request this form to amend or correct. A request for correction of a death record must be made to the Department of Health in the Office of Vital Records or its local representative. If you are a member of the public, you will be required to fill out the appropriate form for the Department. See below and the links included to find the appropriate contact and form. Vital Records — New York The following form is used for requests for alteration, correction or correction of an official death record. Vital Records — New York Death Certificate Application for Corrective Amendment or Correction or for Addition and/or Correction of a Death Record (PDF) For corrections, request this form to amend or correct. See below and the links included to find the appropriate contact and form. Vital Records — West Virginia DU-11 Request for Correction of Death Certificate (DU-117) DU-112.01 Application for Corrective Amendment of Death Record (DU-118) DU-110.00 Application for Addition and/or Correction of Death Record(DU-109) DU-112.02 Request for Correction of Death Certificate DUR-107.01 Application to Amend, Correct or Add to a Death Record for Correction DUR-108.00 Application for Adjustment of Death Record (PDF) DUR-109.00 Application for Correction of Vital Records Record of Death (PDF) DUR-110.00 Application for Medical Corrections of Death Record in the Office of Vital Records (PDF) Application for Correction of a Death Record In most instances, all the information requested on the form will be listed for you, and only a few required items may be listed. Application for Correction of a Death Certificate A physician (e.g., a physician assistant) or nurse practitioner certifies the patient's death during an examination. To do so, the physician or nurse practitioner submits an Application for Correction of Death Certificate, which will be filed with the Vital Statistics Administration. The application for adjustment of a record of death can be completed by a licensed physician, physician assistant, nurse practitioner or nurse practitioner intern.

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