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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION DEATH REPORT INSTRUCTIONS LICENSEE MUST REPORT THE DEATH OF A CLIENT OF ANY CAUSE REGARDLESS OF WHERE THE DEATH OCCURRED. O. B. TELEPHONE NUMBER SEX DATE OF ADMISSION PLACE OF DEATH DATE AND TIME OF DEATH DESCRIBE IMMEDIATE CAUSE OF DEATH IF CORONER REPORT MADE SEND COPY WITHIN 30 DAYS DESCRIBE CONDITIONS PRIOR TO OR CONTRIBUTING TO DEATH EXPLAIN WHAT IMMEDIATE ACTION WAS TAKEN INCLUDE PERSONS CONTACTED MEDICAL TREATMENT NECESSARY YES NO NAME OF ATTENDING PHYSICIAN IF YES GIVE NATURE OF TREATMENT NAME OF MORTICIAN NAME AND TITLE DATE REPORT SUBMITTED BY REPORT REVIEWED/APPROVED BY AGENCIES/INDIVIDUALS NOTIFIED SPECIFY NAME AND TELEPHONE NUMBER LICENSING ADULT/CHILD PROTECTIVE SERVICES LONG TERM CARE OMBUDSMAN PARENT/GUARDIAN/CONSERVATOR LAW ENFORCEMENT PLACEMENT AGENCY LIC 624A 7/99. NOTIFY LICENSING AGENCY PLACEMENT AGENCY AND RESPONSIBLE PERSONS IF ANY BY ....

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In California, requesters can only obtain death records at a fee at the California Department of Public Health - Vital Records (CDPH-VR), the county recorders, and the county health departments. These agencies are authorized by law to provide records of a California birth, death, marriage, or death to the public.

An undetermined manner of death is assigned to cases of unnatural death when a clear preponderance of evidence supporting a specific manner (homicide, accident, or suicide) is not available.

Free; index of death records created by the California Department of Health Services. Also on Ancestry.com ($) and MyHeritage ($), free at FamilySearch centers. ($); Free at FamilySearch centers. Index and images of California death and burial records provided by the California State Archive.

How to Get a Certified Copy Of A California Death Certificate Submitting a mail-in request to the California Department of Public Health - Vital Records. Submitting a virtual request to VitalChek. Submitting a request to the County Recorder or County Clerk in the jurisdiction where the death certificate was issued.

First, Look in Newspapers, Hospital, Cemetery and Funeral Home Records. Hospital records can provide extremely valuable information about your ancestors and can give a cause of death when you can't find a certificate. And while these records are limited, there is a wider selection available than in the past.

If you find someone listed in the Social Security Death Index you can usually order a copy of the form they filled out when they applied for a Social Security Card (SS-5 application) from the Social Security Administration for a fee.

First, Look in Newspapers, Hospital, Cemetery and Funeral Home Records. Hospital records can provide extremely valuable information about your ancestors and can give a cause of death when you can't find a certificate. And while these records are limited, there is a wider selection available than in the past.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Content Takedown Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232