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The Florida Department of Health works to protect, promote & improve the health of all people in Florida through integrated state, county, & community efforts.

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Death Certificate Forms

Birth/Death Certificates

Application for a Florida Death Record  (DH 1961)

Anyone may apply for a death certification. When cause of death information is also requested and the death occurred less than 50 years ago, a valid photo identification must accompany this application or if a mail request, a copy of the valid photo identification, front & back, must be provided; AND the applicant OR person being represented must be an eligible person as outlined in statute (see Eligibility on the back of the form). Relationship to the decedent must be entered in the space provided at the bottom of this form when requesting cause of death. If applicant is a funeral director or an attorney, see additional information under eligibility on back of the form to ensure proper completion of this application.

Death Record Application (English)

Death Record Application (Creole)

Death Record Application (Español)

 

Application for Amendment to Florida Death or Fetal Death Record (DH 524)

The Application for Amendment to a Florida Death Record is used to change an already existing death record.  Correcting medical information or missing data are the common uses for this form.  See the form instructions for further information.

Amendment to Florida Death or Fetal Death Record Application (English)

 

Affidavit to Release Cause of Death Information (DH 1959)

If you are eligible to receive a Florida death certificate, you may use this form to name another person to receive the death certificate for you.

Affidavit to Release Cause of Death Information Form  (English)