Try for free

NCHS Physician's Handbook on Death Certification (2023)

Physicians, nurse practitioners, physician assistants and other medical certifiers use this NCHS handbook when completing the medical part of a death certificate based on the 2003 revision of the US Standard Certificate of Death. It explains how to report the chain of events in Part I, contributing conditions in Part II, intervals, manner of death and the certifier items. The 2023 revision adds guidance on drugs, dementia and diabetes.

Who completes it

It is a reference, not a form. The attending physician, medical examiner or coroner completes the cause-of-death section of the state's death certificate, while funeral directors complete the demographic items with an informant.

Submitting and payment

How to submit it
Nothing is submitted; certifiers deliver the signed or electronically authenticated certificate to the funeral director promptly, using the state's electronic death registration system or current paper form.

Good to know

  • Never report a mechanism such as cardiac arrest or respiratory arrest as the immediate cause on line a; report the disease, injury or complication causing death.
  • Report the interval from onset to death for every Part I condition; write Unknown rather than leaving it blank, and avoid abbreviations.
  • Name the organism for infections, the type of stroke, dementia or diabetes, and every drug involved in drug-related deaths, without brand names.
  • If autopsy findings or new information change the cause, report the revised cause to the state vital records office or local registrar immediately.

Get the official form

Download the current version from the source each time; forms change without notice.

Physician's Handbook on Medical Certification of Death (2023 Revision)

Official pagePDF

Fill it with Vero

If your copy of the form is a fillable PDF, upload it once and Vero Documents fills it from the visit note and the chart, ready for you to review and sign. Download, print, or email the finished form, with the patient’s consent.

See how Vero Documents works

How this list is checked

A form is listed only after its name and number were confirmed on the issuing agency’s or insurer’s own website, or in the form itself. Each entry links to that source. The list was last checked in October 2026. Forms and their requirements change without notice, so check the official page for the current version before you complete one.

Vero is not affiliated with, or endorsed by, the agencies and insurers listed here. Read our editorial policy.

Frequently asked questions

What goes in Part I versus Part II of the cause of death?

Part I lists the chain of events, with the immediate cause on line a and the underlying cause, the condition that started the sequence, on the lowest line used. Part II lists other significant conditions that contributed to death but did not lead to the underlying cause. Do not use Part II to continue the sequence.

Can a cause of death be listed as pending?

In some states a certificate can be submitted with the cause listed as pending or pending further study, which helps when an autopsy or other investigation is expected. The certifier should update the information as soon as results are available, and a condition may be qualified as probable if not definitively diagnosed.