WA DOH 422-023 2013 free printable template
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Washington State Fetal Death Certificate Local File Number 1. Name of Fetus First Delivery Information Middle 2. Sex (M/F/UK) 1 2 LAST 3. Date of Delivery (MM/DD/YYY) / / 5a. Type of Birthplace (Specify
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How to fill out WA DOH 422-023
How to fill out WA DOH 422-023
01
Begin by obtaining the WA DOH 422-023 form from the Washington State Department of Health website.
02
Fill out the personal information section, including your name, address, phone number, and email.
03
Specify the type of request or application you are submitting by selecting the appropriate option in the form.
04
Provide detailed information related to your request in the designated sections, ensuring accuracy and clarity.
05
If applicable, include any necessary supporting documentation as specified in the form instructions.
06
Review the completed form for any errors or missing information.
07
Sign and date the form as required.
08
Submit the completed form according to the instructions provided, either by mail, email, or online submission.
Who needs WA DOH 422-023?
01
Individuals or entities seeking to obtain health data or records from the Washington State Department of Health.
02
Public health professionals who require access to specific health information for research or analysis.
03
Healthcare providers needing to fulfill regulatory requirements regarding health data.
04
Organizations involved in public health planning or policy-making.
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People Also Ask about
Are Washington death certificates public record?
The State of Washington is an open record state. Anyone may order copies of Washington death certificates, as long as they can provide the required information. If you do not want to order the death record, search other records with death information.
How do I get a death certificate in Washington?
Submit an application with required pieces of information. Provide valid government identification or alternate identification. Provide documentation to prove your qualifying relationship. Pay applicable fee(s). Fees start at $25 per certificate. Other fees may apply depending on ordering or shipping method.
Who signs a death certificate in Washington state?
Medical certifiers include allopathic and osteopathic physicians, physician assistants, advanced registered nurse practitioners, chiropractors, coroners and medical examiners to follow when completing death certificates.
Who files death certificate in Washington state?
After completing the autopsy, the Medical Examiner files a death certificate with the Washington Department of Health indicating the cause and manner of death.
Who certifies the cause of death when someone dies?
In signing the death certificate, the physician, medical examiner, or coroner certifies that, in his/her medical opinion, the individual died from the reported causes of death.
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What is WA DOH 422-023?
WA DOH 422-023 is a form utilized by the Washington State Department of Health for reporting specific health-related data.
Who is required to file WA DOH 422-023?
Certain healthcare providers and organizations that fall under the jurisdiction of Washington State health regulations are required to file WA DOH 422-023.
How to fill out WA DOH 422-023?
To fill out WA DOH 422-023, individuals must provide accurate and relevant health data as stipulated in the instructions provided with the form, including details related to patient information and health services rendered.
What is the purpose of WA DOH 422-023?
The purpose of WA DOH 422-023 is to collect data that assists in monitoring public health trends and ensuring compliance with state health regulations.
What information must be reported on WA DOH 422-023?
The information that must be reported on WA DOH 422-023 includes patient demographics, health conditions treated, services provided, and any other relevant health data as required by the form.
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