Death certificates revised for start of new year

Beginning Jan. 1, 2012, the Department of Vital Records is implementing a revised Certificate of Death that will replace the white death certificate currently used for all neonates and adults.

The certificate changes from a standard paper size to a legal-size paper. As always, the death certificate must still be completed using black ink and crossing out and rewriting information will result in the rejection of the certificate. The pronouncing and certifying physician will be required to complete a new certificate. Also, the certificate should not be folded.

Items 1-22 are to be completed by the funeral home and must be left blank. Items 23-42 must be completed by the responsible physician. The patient’s name at the time of death is to be written along the left-hand margin. The following table provides detailed explanations for the revisions that will affect the physician completing the certificate.

 
Revised/Dropped

 
Field

Items on Previous Certificate

Items on Revised Certificate

 

 

 

 

Revised

Was Case referred to Medical Examiner/Coroner?

Item 26 included the phrase, “For a reason other than cremation or donation.”

Item 25 now states, “Was medical examiner or coroner contacted?”

Revised

Cause of Death Part II: Enter other significant conditions contributing to death but not resulting in the underlying cause given in Part I.

Cause of Death Part II: Had four lines corresponding to the four lines in Cause of Death Part I.

Item 26 – Part II is now an open box meant for free-form entry.

Revised

Location of Injury

Item 32g: Street, City/Town, State

Item 35: Street and Number, City, State, ZIP Code

Revised

Certifier (Check only one)

Item 33a: Formerly listed three choices (certifying physician, pronouncing and certifying physician, and Medical Examiner/Coroner). Also had a definition for each choice.

Item 39a: Continues to list the same three choices but without the definitions.

Revised

File Date

Item 26: Date Filed (Month, day, year)

Item 42: Registrar File data (Month/day/year)

Dropped

Instructions on back of certificate

Cause of Death Examples

No instructions listed on back of certificate