Washington State Fetal Death CertificateDOH 422023 May 2021Local File Number 1. Name of Fetus FirstMiddle2. Sex (M/F/Unk)LAST3. Date of Delivery (MM/DD/YYYY) / /5a. Type of Birthplace (Specify Type).

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How to fill out the WA DOH 422-023 online

The Washington State Fetal Death Certificate, known as WA DOH 422-023, serves as an important official document recorded after a fetal death. This guide provides clear and supportive instructions for users to complete the form accurately and efficiently online.

Follow the steps to successfully complete the WA DOH 422-023 form.

  1. Click ‘Get Form’ button to access the WA DOH 422-023 online and open it in your preferred editor.
  2. Start by entering the name of the fetus in the designated fields for first, middle, and last names. Ensure spelling is correct, as this is a vital component of the certificate.
  3. Indicate the sex of the fetus by selecting 'M' for male, 'F' for female, or 'Unk' for unknown.
  4. Input the date of delivery using the format MM/DD/YYYY. This is important for tracking and record-keeping purposes.
  5. Select the type of birthplace from the options provided, whether it is a hospital, freestanding birth center, clinic, or home. Provide the name of the facility, if applicable.
  6. Complete the time of delivery in the 24-hour format and provide the city or town of the delivery.
  7. Fill in the parent's information by entering their names as they appear on their birth certificates, including date of birth and current legal names, if different.
  8. Complete the disposition section including the method of disposition like burial or cremation, and provide all relevant dates.
  9. Finalize by ensuring all required fields throughout the document are filled in. Once the form is complete, you can then save changes, download, print, or share the completed document as necessary.

Complete your WA DOH 422-023 form online today for accurate documentation.

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