DOH Form 422-023 Washington State Fetal Death Certificate - Washington

DOH Form 422-023 Washington State Fetal Death Certificate - Washington

What Is DOH Form 422-023?

This is a legal form that was released by the Washington State Department of Health - a government authority operating within Washington. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is DOH Form 422-023?A: DOH Form 422-023 is the Washington State Fetal Death Certificate.

Q: What is the purpose of DOH Form 422-023?A: The purpose of DOH Form 422-023 is to document information about a fetal death in Washington State.

Q: Who uses DOH Form 422-023?A: DOH Form 422-023 is used by healthcare providers, funeral directors, and individuals who need to report or obtain a fetal death certificate in Washington State.

Q: What information is required on DOH Form 422-023?A: DOH Form 422-023 requires information such as the baby's name (if named), date and place of fetal death, parent's information, and the attending healthcare provider's information.

Q: Are there any fees associated with DOH Form 422-023?A: Yes, there is a fee for obtaining a certified copy of the Washington State Fetal Death Certificate using DOH Form 422-023. The fee varies depending on the number of copies requested.

Q: What should I do with completed DOH Form 422-023?A: Once completed, DOH Form 422-023 should be submitted to the Washington State Department of Health Vital Records office or mailed to the address provided on the form.

ADVERTISEMENT

Form Details:

  • Released on October 1, 2015;
  • The latest edition provided by the Washington State Department of Health;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of DOH Form 422-023 by clicking the link below{class="scroll_to"} or browse more documents and templates provided by the Washington State Department of Health.

Download DOH Form 422-023 Washington State Fetal Death Certificate - Washington

4.8 of 5 (79 votes)
  • DOH Form 422-023 Washington State Fetal Death Certificate - Washington

    1

  • DOH Form 422-023 Washington State Fetal Death Certificate - Washington, Page 2

    2

  • DOH Form 422-023 Washington State Fetal Death Certificate - Washington, Page 1
  • DOH Form 422-023 Washington State Fetal Death Certificate - Washington, Page 2
Prev 1 2 Next
ADVERTISEMENT