NEW MoEVR 2.0 - COMING SOON

MoEVR Missouri DHSS

The Missouri Department of Health and Senior Services, Bureau of Vital Records, is designing a brand new Missouri Electronic Vital Records (MoEVR 2.0) system with a phased implementation period occurring over the fall of 2024 to the spring of 2026. Additional correspondence and detailed information on the conversion process will be sent to all currently registered MoEVR users prior to go-live.

 

Phase I – Death Registration (Spring 2025) | Phase II – Birth and Fetal Death Registration (Winter 2025) | Phase III – LPHA Issuance (Spring 2026)

LOGIN TO MoEVR 1.0

Register: If you are a licensed professional and would like to request access to register vital events electronically using the Missouri Electronic Vital Records (MoEVR) system, simply complete the MoEVR User Access Request form and email it to MoEVRsupport@health.mo.gov

For support: (M-F 9 AM – 4 PM) Call MoEVR Support 573-751-6387 - option 4 or email MoEVRsupport@health.mo.gov

Birth

Registering a Missouri Birth

A certificate of live birth for each birth occurring in Missouri must be filed within five (5) days after the date of birth and must follow all other provisions as outlined in Section 193.085, RSMo. The certificate of live birth is filed with the Missouri Department of Health and Senior Services per state law. While vital record keeping began on January 1, 1910, changes in data items and definitions have taken place over the years.

Live birth is defined by statute as the complete expulsion or extraction from its mother of a child, irrespective of the duration of pregnancy, which after such expulsion or extraction, breathes or shows any other evidence of life such as beating of the heart, pulsation of the umbilical cord, or definite movement of voluntary muscles, whether or not the umbilical cord has been cut or the placenta is attached. The definition is also irrespective of birth weight.

Live birth certificate data is used in estimating population, for evaluation of maternal and perinatal health, for the study of fertility patterns, and to assist public health officials in the conduct and evaluation of programs.

If you are attempting to register a Missouri birth and are a hospital or licensed institution, see information here: In Hospital or Institution Births. If you are a mother, father, midwife, or other similar individual, see information here: Out of Hospital/Institution Births or Home Births.

In Hospital or Institution Births

When a birth occurs in an institution or en route to an institution, the person in charge of the institution or such person's designated representative shall obtain the personal data, prepare the certificate, certify that the child was born alive at the place and time and on the date stated either by signature or an electronic process approved by the department, and file the certificate pursuant to this section or as otherwise directed by the state registrar within the required five days. The physician or other person in attendance shall provide the medical information required by the certificate and certify to the facts of birth within five days after the birth. If the physician or other person in attendance does not certify to the facts of birth within the five-day period, the person in charge of the institution shall complete the certificate.

In hospital or institution births are registered electronically in MoEVR by designated hospital or other institution staff. If you need MoEVR access or assistance, email MoEVR support at MoEVRsupport@health.mo.gov or call 573-751-6387.

Out of Hospital/Institution Births or Home Births (0-11 Years of Age)

A certificate of live birth for each birth occurring in Missouri must be filed within five (5) days after the date of birth and must follow all other provisions as outlined in Section 193.085, RSMo. The certificate of live birth is filed with the Missouri Department of Health and Senior Services per state law. Certificates containing erasures, whiteouts, writeovers, or faxes or reproduced copies will NOT be accepted. If your child has reached his/her twelfth birthday and no record was registered, pursuant to Section 193.105.1, RSMo, you will need to use the Delayed Birth process. For additional information, contact the Bureau of Vital Records at 573-751-6387, Option 3.

The certificate shall be prepared and registered by one of the following in the indicated order:

  1. The physician in attendance at or immediately after the birth. Physician may register birth electronically using MoEVR or by paper process outlined below.
  2. Any other person in attendance at or immediately after the birth. If other person in attendance is a certified/licensed professional (RN, APRN, AP, PA, CNM, CPM, and CM), birth may be registered electronically using MoEVR or by paper process outlined below.
  3. The father, the mother, or, in the absence of the father and the inability of the mother, the person in charge of the premises where the birth occurred.

The certificate must be either typed or printed in permanent black ink.

Do not leave any items blank. Indicate unknown for items when information is not known.

Mail completed form to: Bureau of Vital Records, 930 Wildwood Drive, Jefferson City, MO 65109

Download a certificate of live birth to get started and carefully review the directions below. To request a paper copy of a certificate of live birth or for further details about correctly documenting an out of facility birth/home birth, contact the Bureau of Vital Records at 573-751-6387, Option 3.

Completing Data Items

Item 1. Child’s name: First, Middle, Last, Suffix
Item 2. Date of birth: Enter month, day and year child was born. (Example: You can enter the date in the MM/DD/YYYY format or write the entire date out.)
Item 3. Time of birth: Enter exact time of birth and indicate a.m., p.m. or (m) for military
Item 4. Sex: Spell out sex—male or female.
Item 5. City, town, or location of birth: Enter the name of the city, town, village or location where the birth occurred. For births occurring on a moving conveyance, enter the city, town, village, or location where the child was first removed from the conveyance.
Item 6.  County of Birth: Enter the name of the county where the birth occurred. For births occurring on a moving conveyance, enter the county where the child was first removed from the conveyance.
Item 7. Place of Birth: Check the appropriate box. If the birth occurred in an unlicensed facility, check the “other” box and list name of facility.
Item 8. Facility Name: If the birth occurred in a licensed facility, give the name of the facility. If the birth was not in a licensed facility, enter the house or business number and the street name of the place where the birth occurred.
Item 9a. Mother’s Current Legal Name:

Item 9b. Date of Birth:
Enter mother’s legal name at the time of the birth. (first, middle, last)

Enter mother’s date of birth. (Example: You can enter the date in the MM/DD/YYYY format or write the entire date out.)
Item 9c. Mother’s Name Prior to First Marriage: Enter mother’s name prior to first marriage. (first, middle, last) Do not leave this item blank. Do not line through, state “n/a” (for not applicable), or enter the word “same”.
Item 9d. Birthplace: Enter mother’s birthplace. (Enter the country and state of her birth.)

Residence Information

Items 10a-11d. Mother’s Address: Enter mother’s physical address where she was residing at the time the birth occurred on lines 10 a-f. PO Box numbers are not acceptable for items 10a-e. If the mailing address is the same, check the box “same as residence”. Enter current mailing address on lines 11a-d if it is different than the physical address.
Items 12a-c. Father’s Information: Father’s information may only be added to the birth certificate if the parents are legally married, unless the mother and the person to be named as father have completed an Acknowledgment of Paternity forms to submit with the birth certificate, or a determination of paternity has been made by the court. If the father is not named on the certificate, no other information about the father is to be completed on the certificate.
Items 13a-c. Certifier: The certifier may not necessarily be the person who attended the delivery, but may certify to the facts of the birth. The certifier is usually the attendant, staff from a birthing center, or one of the parents. The certifier should sign, date, print name, and mark appropriate box. If the “other” box is marked, state relationship to the child — i.e. father, grandmother, friend, etc.
Item 14. Attendant name and title: When the certifier was not the attendant, type or print the full name of the person in attendance and check the appropriate box to identify the title.
Items 15a-b. Attendant’s MO License Number and Attendant’s NPI Number For licensed medical professionals - Enter personal state medical or nursing license number of the attendant. If the individual possesses no license at all, enter “None”.
Item 16. Registrar’s Signature/Date Filed Leave this field blank.

Affirmation of Birth (Located at bottom of page 1 on the Certificate of Live Birth)

Must be signed by two other individuals not on the face of the certificate in the presence of a notary public. If the attendant is someone other than a parent, he/she may sign the affirmation if he/she is not the certifier. If the certifier on the certificate is a licensed professional (MD, DO, RN, APRN, AP, PA, CNM, CPM, and CM), the mother/father/parents listed on the certificate may sign the affirmation of birth. The witnesses may not have been present at the birth, but must be aware of the facts of the birth.

Please do NOT scratch out, strikethrough, or replace any words or phrases on the certificate such as “do solemnly declare and affirm” or “pains and penalties of perjury”, among others. If the certificate is defaced in any way, it will not be accepted.

Confidential Information (Located on pages 2-3 of the Certificate of Live Birth)

Line 17. Permission to provide Social Security Number: Check box. For births filed after the child’s first birthday, parents should contact Social Security for information on how to obtain a social security number.
Line 18a-c. Marital Information: Note: The “yes” box on line 18a refers to a marriage that is legally recognized by the State of Missouri.
Line 19-61. Health, Education, Medical Information: Complete all information. Do not leave items blank.

Evidence of Birth

Provide the following evidence to support the facts of birth and submit with the Certificate of Live Birth. Suggested documents include, but are not limited to:

  1. Evidence of the pregnancy
    • Prenatal or postnatal record consistent with the date of delivery
    • Physician statement
    • Hospital, clinic, or laboratory record
    • A notarized, sworn statement from two different, unrelated individuals, not appearing on the face of the certificate, that the mother was pregnant during a period of time related to the birth being recorded on the Certificate of Live Birth form.
  2. Evidence of the mother’s residence in this state at the time of the birth
    Evidence documents must include mother’s name, address, and be from month and year of birth.
    • Prenatal or postnatal record consistent with the date of delivery
    • Physician statement
    • Hospital, clinic, or laboratory record
    • Public health office statement
    • Statement from medical provider
    • Utility or telephone bill
    • Rent receipt
    • Pay stub
    • Bank statement
    • Social service record if receiving public assistance (i.e. WIC, food stamps, child support, etc.)

Out of State Residents

If the mother resides out of state, proof of presence in Missouri during delivery in lieu of proof of residency during delivery is required. Evidence from the day of delivery include, but are not limited to:

  • Gas receipt
  • Purchase/sales receipt
  • Notarized driver/transportation statement
  • Travel documents/itineraries

Evidence of Birth Exceptions

Licensed Professional (MD, DO, RN, APRN, AP, PA, CNM, CPM, and CM)
All out of facility births require a notarization of the Certificate of Live Birth to properly document the birth. If a licensed professional signs as the certifier and includes their license number on a Certificate of Live Birth, proof of pregnancy and residency is not required to be submitted with the notarized Certificate of Live Birth. Proof of current and valid licensure is required.

Appeal of Decision

If at any time in this process, the State Registrar has cause to question the validity or adequacy of the applicant’s statement or the documentary evidence, and if the deficiencies are not corrected, the State Registrar shall not register the birth. If the State Registrar does not register the Certificate of Live Birth, you may appeal the Bureau’s decision to a court of competent jurisdiction and obtain a court order to create a birth certificate for the child.

Delayed Birth Certificates - Over 1 Year of Age but Under 12 Years of Age

The procedures for filing delayed birth certificates within one year or more after the date of birth but before 12 years after the date of birth are the same as outlined above. In accordance with 19 CSR 10-10.030: (A) The child must be born in Missouri; (B) There must be no prior certificate on file in the Bureau of Vital Records which can reasonably be presumed to belong to the child; and (C) The registration shall be on current certificates of live birth. The basic procedure shall be as nearly as practicable the same as for filing a current live birth certificate. However, pursuant to 193.105, RSMo: certificates of birth registered one year or more after the date of birth shall be made on forms prescribed and furnished by the state registrar, marked "Delayed", and shall show on their face the date of the delayed registration.

Delayed Births (12+ Years of Age)

Instructions to File a Delayed Certificate of Birth in Missouri

(Only a person who is now 12 years of age or older born in Missouri currently without a registered birth certificate will utilize this process to record their birth and create a delayed birth certificate)

  1. AFFIDAVIT on Page 1:
    1. Give the facts as of the time of your birth. (If you have been adopted, write to the Bureau of Vital Records for special instructions.)
    2. Registrant must sign in present legal name in the presence of a notary public and include the notary’s signature, date of signature, and date of expiration of commission. (The notary should not be related to registrant.)
  1. AFFIDAVIT on Page 2:
    1. Have a parent prepare and sign the Supporting Affidavit before a notary public.
    2. If both parents are deceased, have an OLDER relative or an OLDER long-time acquaintance prepare the affidavit. This person must state how he came to know about your date and place of birth. (Not husband/wife.)
  1. TWO DOCUMENTS (of different types) are required to verify your name, date and place of birth. (Suggested documents may be found below.)
    1. Observe the following as each document must show:
      • Your full correct name when you were born.
      • Your correct birth date and place of birth, and one document must give parents names.
      • The source of the document (its name and location).
      • The date the document was made (filed). (The document must be over 5 years old.)
    2. The older the document, the stronger its probative value.
    3. An altered document is not acceptable.
    4. Personal knowledge affidavits are not accepted in lieu of documents.
  1. Return your application, two documents, and proper fee. (Documents MUST accompany the application.)
    1. A certified copy of the certificate, or any part of it, is $15.00.
    2. A fee of $15.00 if required for processing.
    3. Make check or money order payable to: Missouri Department of Health. Jefferson City Missouri.
    4. Other forms of remittance at sender’s risk.

Additional Information

  1. The Bureau of Vital Records was established in 1910. Delayed registration of persons born prior to 1910 was begun in 1931, and then only by request.
  2. The Bureau of Vital Records has authorized NO ONE to represent it for handling delayed certificates. Do not give money to anyone who claims to be an agent of this office.
  3. If you are 62 or over, contact the Social Security Board local office, your county Welfare office, the Railroad Retirement Board, etc, regarding their requirements before submitting your application to the Bureau of Vital Records.
  4. Every state has a procedure to file a delayed birth certificate. You should make every effort to file in your state of birth.
  5. A delayed birth certificate cannot be filed for a deceased person. (His death certificate gives all the data which would appear on the delayed birth certificate. The death certificate also includes citizenship.)
  6. A delayed certificate that is incorrect or inadequate can be changed by COURT ORDER ONLY.

(The delayed birth certificate application form and these instructions have been filed with the Missouri Secretary of State to conform with law.)

SUGGESTED DOCUMENTS
(Send two)

Baptismal, Cradle Roll, or other Church Record
If the registrant does not have such record, he should write to the present pastor of the church where the record was created. If the record is in a foreign language, the essential information should be translated. The officer holding the record shall certify to the facts using his official title and seal or letterhead. The name and date of birth or age must appear on the record.

Physician, Dentist, Optometrist, or Hospital Record
Can be either a copy of a record in their files or a statement on their stationery that states registrant’s full name at birth, date of birth, name and address of the physician or hospital, and date you were first seen by the doctor or admitted to the hospital. Document must be over 5 years old.

Child’s Birth Record
Must be obtained from the State Vital Records Office in the state the child was born. Must show your full name, age, place of birth, child’s full name, child’s date of birth, state file number, and must bear the state seal. Hospital birth records are not acceptable. Document must be over 5 years old. If an amendment has been made on the child’s birth record, the amendment must be over 5 years old.

Insurance Policy (Life, Health, and Accident, Hospital, Burial Benefits, etc.)
Most insurance policies are excellent documents since they usually carry the registrant’s name, exact date and place of birth and date policy application was made. Be sure your policy is five or more years old. If the policy is not now in your possession for any reason, write the Company for the information you need. DO NOT SEND A STATEMENT BASED ON A POLICY UNLESS IT IS PREPARED BY THE COMPANY’S AGENT FROM HIS RECORDS. An affidavit regarding a policy cannot be accepted. Policy must give name and address if company.

Military Record
Must show your full name, date of birth, place of birth, date you entered the service, your service number, and the date you were discharged.

School Record or School Enumeration Record
Applicant may be able to obtain a record from the superintendent of the school attended, the county superintendent of schools, or the county clerk. The record must show age or date of birth, birthplace, and the date record was prepared. The officer holding the record shall certify to these facts using the official title and seal or letterhead.

Employment Application
Can be either a copy of the records in their files or a statement on their stationery that states your full name, date of birth, date you applied for the job or the date you were hired and the company’s name and address. This may be obtained from their Personal Office. Document must be over 5 years old.

Voter Registration Application
Obtained from the County Clerk’s office. Must show your full name at birth, date of birth, place of birth, county and state registered in, and the date you registered. Document must be over 5 years old.

Social Security Numident
This is a computer print-out of the application that you completed at the time you applied for your Social Security Number and can be obtained from your local Social Security Office.

Marriage License Application
Obtained from the Recorder of Deeds Office in the county you obtained your marriage license. Must show your full name, age, date applied, county and state where you obtained your license, and must be over 5 years old.

Many more acceptable records are available. If you have two that fit your affidavit on Page 1, send them for review. Driver’s licenses, fraternal order membership applications, and U.S. Passport are a few other suggestions. Rarely does a registrant fail to have several acceptable documents.

Appeal of Decision

If at any time in this process, the State Registrar has cause to question the validity or adequacy of the applicant’s statement or the documentary evidence, and if the deficiencies are not corrected, the State Registrar shall not register the birth. If the State Registrar does not register the Certificate of Live Birth, you may appeal the Bureau’s decision to a court of competent jurisdiction and obtain a court order to create a birth certificate for the child.

Court Ordered Certificate of Live Birth

When a certificate of birth of a person born in this state has not been filed within the time period provided in section 193.085, RSMo, a certificate of birth may be filed in accordance with regulations of the Department of Health and Senior Services and registered subject to such evidentiary requirements as the department shall by regulation prescribe to substantiate the alleged facts of birth. See Out of Hospital/Institution Births or Home Births or Delayed Births for more information.

However, pursuant to section 193.105, RSMo, when an applicant does not submit the minimum documentation required in the regulations for delayed registration, or when the state registrar has reasonable cause to question the validity or adequacy of the applicant's sworn statement or the documentary evidence, and if the deficiencies are not corrected, the state registrar shall not register the delayed certificate of birth and shall advise the applicant of the reasons for this action, and shall further advise the applicant of his or her right of appeal to a court of competent jurisdiction.

The certified court order must instruct the Bureau of Vital Records to establish a Certificate of Live Birth that includes the information below. The list below does not include all items on the birth certificate. 19 CSR 10-10.040 lists the complete contents of Missouri’s birth certificate and the court order may include those additional items if it chooses to do so (such as permission given to Social Security Administration to provide Social Security number, mother and/or father of Hispanic origin, mother and/or father education, etc.)

However, at a minimum, the court order should include the following data elements:

(If any data elements are unknown, indicate unknown. Note: some data elements, such as county of birth, must be provided or a Certificate of Live Birth cannot be created.)

  • Child’s legal name (first, middle, last, and suffix--if any);
  • Child’s date of birth
  • Child’s sex
  • City, town, or location of birth
  • County of birth
  • State of birth—must be Missouri
  • Place of birth
    • Hospital
    • Home birth (Planned? Yes/no)
    • Freestanding birth center
    • Clinic/doctor’s office
    • Other (Specify)
  • Facility name (If not an institution, provide number and street of where child was born)
  • Mother’s current legal name (First, middle, last)
  • Mother’s date of birth
  • Mother’s name prior to first marriage (First, middle, last—may be same as current legal name)
  • Mother’s place of birth (Country and state)
  • Residence of mother at time of birth (Country, state, county, city, town, or location, street and number of address, ZIP code, and inside city limits? Yes/no)
  • Current mailing address of mother
  • Marital status of mother at conception, birth, or anytime in between?
  • Father’s current legal name (First, middle, last, suffix)
  • Father’s date of birth
  • Father’s place of birth (Country and state)
  • Attendant’s name and title

Upon receipt of a certified court order, the Bureau of Vital Records will prepare and register the birth certificate based on the information in the court order. To obtain a copy of the birth certificate after registration, a search fee is required. For more information, view how to obtain a copy of a vital record.

Court Ordered Certificate of Live Birth (12+ Years of Age)

For obtaining a court order for the filing of a delayed birth certificate for a person who has passed his/her twelfth birthday, and the state registrar has refused to register a delayed birth certificate, you may view Petition for Establishing Record of Birth and Order to Establish Record of Birth.

Upon receipt of a certified court order, the Bureau of Vital Records will prepare and register the birth certificate based on the information in the court order. To obtain a copy of the birth certificate after registration, a search fee is required. For more information, view how to obtain a copy of a vital record.

Foreign Born Adoptions

Foreign born children adopted by Missouri residents can have a new birth certificate created for their child in one of two processes:

  1. Adoptive parents or applicable attorney can submit all required foreign born documents to the bureau, in which those documents become a permanent part of the record and a new foreign born Missouri birth certificate is created. This certificate does not serve as proof of citizenship.

    The proof of adoption required by the Department shall include:
    • a copy of the original birth certificate and adoption decree
    • an English translation of such birth certificate and adoption decree; the authenticity of the translation of the birth certificate and adoption decree required shall be sworn to by the translator in a notarized document
    • a copy of the approval of the immigration of the adopted person by the Immigration and Naturalization Service of the United States government which shows the child lawfully entered the United States
    • In addition to the above documentation, information regarding the adopted parents is necessary to establish the birth certificate. Complete the Request for Filing Birth Certificate as Result of Foreign Adoption and return to the Bureau of Vital Records for processing.
  1. Foreign born adoption recognized by a Missouri court of competent jurisdiction and then that court will forward the Certificate Decree of Adoption to vital records.

Fees: $15.00 to process foreign born paperwork/court order. Additional $15.00 for copy of new birth certificate. Make check or money order payable to the Missouri Department of Health and Senior Services.

Same-Sex Couples

The following guidance outlines birth registration information with same-sex couples in Missouri:

  • Women in same-sex marriages, lawfully entered into in jurisdictions where same-sex marriage legal, who give birth in Missouri, may choose to have their spouse listed as the baby’s co-parent on the birth certificate.
  • The person who gives birth to a child is always listed as the mother. In instances, where the mother wishes to list the biological dad on the birth certificate, she can list the father in lieu of the female spouse. The female spouse does not sign a Husband’s Denial of Paternity. In this case, the birth record is registered with only the mother on the record. Information for the “co-parent” is not added and the mother and father will need to complete paternity affidavits to add the father to the birth record after the record is registered.
  • A mother in a same-sex marriage who refuses to provide her spouse’s information on the record at the time of birth will require a court order to add the co-parent later.
  • Men in same sex relationships or marriages (using a donor egg/surrogate) will have the person who gives birth to the child listed as the mother. Paternity affidavits are then needed to add the biological father. If the couple choose to mix sperm, either father may be listed. Finally, a court order is then needed to remove the mother and add the father’s spouse/co-parent.
  • Unmarried same sex female couple using donor sperm.
    The person who gives birth to a child is listed as the mother. No father is listed on the birth certificate. A court order is required to add co-parent.
  • If a same sex female couple is not married, the person who gives birth to a child is listed as the mother, and then a court order is needed to list her partner.

For more information or guidance on additional scenarios, contact the Bureau of Vital Records at 573-751-6387, Option 4.

Death

Registering a Missouri Death

A certificate of death for each death occurring in Missouri must be filed within five (5) days after the date of death (Section 193.145, RSMo) with the Missouri Department of Health and Senior Services by state law. While vital record keeping began on January 1, 1910, changes in data items and definitions have taken place over the years.

If the place of death is unknown but the dead body is found in this state, the certificate of death shall be completed and filed pursuant to the provisions of 193.145, RSMo. The place where the body is found shall be shown as the place of death. The date of death shall be the date on which the remains were found.

When death occurs in a moving conveyance in the United States and the body is first removed from the conveyance in this state, the death shall be registered in this state and the place where the body is first removed shall be considered the place of death. When a death occurs on a moving conveyance while in international waters or air space or in a foreign country or its air space and the body is first removed from the conveyance in this state, the death shall be registered in this state but the certificate shall show the actual place of death if such place may be determined.

The funeral director or person in charge of final disposition of the dead body shall file the certificate of death. The funeral director or person in charge of the final disposition of the dead body shall obtain or verify and enter into the electronic death registration system:

  1. The personal data from the next of kin or the best qualified person or source available;
  2. The medical certification from the person responsible for such certification if designated to do so under subsection 5 of this section; and
  3. Any other information or data that may be required to be placed on a death certificate or entered into the electronic death certificate system including, but not limited to, the name and license number of the embalmer.

The medical certification shall be completed, attested to its accuracy either by signature or an electronic process approved by the department, and returned to the funeral director or person in charge of final disposition within seventy-two hours after death by the physician, physician assistant, assistant physician, advanced practice registered nurse in charge of the patient's care for the illness or condition which resulted in death.

In the absence of the physician, physician assistant, assistant physician, advanced practice registered nurse or with the physician's, physician assistant's, assistant physician's, or advanced practice registered nurse's approval the certificate may be completed and attested to its accuracy either by signature or an approved electronic process by the physician's associate physician, the chief medical officer of the institution in which death occurred, or the physician who performed an autopsy upon the decedent, provided such individual has access to the medical history of the case, views the deceased at or after death and death is due to natural causes. The person authorized to complete the medical certification may, in writing, designate any other person to enter the medical certification information into the electronic death registration system if the person authorized to complete the medical certificate has physically or by electronic process signed a statement stating the cause of death. Any persons completing the medical certification or entering data into the electronic death registration system shall be immune from civil liability for such certification completion, data entry, or determination of the cause of death, absent gross negligence or willful misconduct. The state registrar may approve alternate methods of obtaining and processing the medical certification and filing the death certificate. The Social Security number of any individual who has died shall be placed in the records relating to the death and recorded on the death certificate.

When death occurs from natural causes more than thirty-six hours after the decedent was last treated by a physician, physician assistant, assistant physician, advanced practice registered nurse, the case shall be referred to the county medical examiner or coroner or physician or local registrar for investigation to determine and certify the cause of death. If the death is determined to be of a natural cause, the medical examiner or coroner or local registrar shall refer the certificate of death to the attending physician, physician assistant, assistant physician, advanced practice registered nurse for such certification. If the attending physician, physician assistant, assistant physician, advanced practice registered nurse refuses or is otherwise unavailable, the medical examiner or coroner or local registrar shall attest to the accuracy of the certificate of death either by signature or an approved electronic process within thirty-six hours.

If the circumstances suggest that the death was caused by other than natural causes, the medical examiner or coroner shall determine the cause of death and shall complete and attest to the accuracy either by signature or an approved electronic process the medical certification within seventy-two hours after taking charge of the case.

If the cause of death cannot be determined within seventy-two hours after death, the attending medical examiner, coroner, attending physician, physician assistant, assistant physician, advanced practice registered nurse, or local registrar shall give the funeral director, or person in charge of final disposition of the dead body, notice of the reason for the delay, and final disposition of the body shall not be made until authorized by the medical examiner, coroner, attending physician, physician assistant, assistant physician, advanced practice registered nurse, or local registrar.

Death certificate data can be used to assess the status of health, evaluate the effectiveness of programs, and make population estimates.

In Missouri, when the final disposition of a deceased individual is handled by a licensed funeral director, the death record is started electronically in MoEVR and medical certification is electronically completed by a medical certifier. Following certification, the record is then electronically registered with the state by the licensed funeral director. If you need MoEVR access or assistance, email MoEVR support at MoEVRsupport@health.mo.gov or call 573-751-6387. When a death occurs in Missouri and someone other than a funeral director is in charge of the final disposition, the death record will need to be registered with the state following the home burial process.

Certifying Cause of Death

In Missouri, physicians (MD/DO), physician assistants, assistant physicians, advanced practice registered nurses, coroners, and medical examiners are authorized by state law to medically certify death certificates.

The law allows the medical certifier to designate any other person to enter the medical certification information into the Missouri Electronic Vital Record (MoEVR) system if the medical certifier has physically or by electronic process signed a statement stating the cause of death. MoEVR currently has a data entry role that will allow someone other than the certifier to enter the information. However, someone other than the medical certifier is not permitted to electronically certify the record.

If a medical certifier chooses to designate someone to enter, into MoEVR, the medical certification information on the certifier’s behalf, a User Access Request form is required from the user requesting access as the appropriate data entry clerk. The medical certifier must be listed and the form signed by the user and the medical certifier for system access to be granted.

Home Burials

When a death occurs in Missouri and someone other than a funeral director is in charge of the final disposition, the other person must submit a written request to the Missouri Bureau of Vital Records for a blank death certificate to start the registration process. Section 193.145.4 RSMo requires the person in charge of final disposition of the body to file the certificate of death.

The written request must, at a minimum, include the following items:

  • Decedent’s legal name (including last name prior to first marriage if female)
  • Date of death
  • Date of birth
  • Place of death (including facility name, if applicable, city, state and county)
  • Name, full address, and telephone number of medical certifier (medical certifier may be a ME/coroner, MD, DO, APRN, AP, or PA)
  • Name of requestor and relationship to decedent
  • Requestor’s mailing address
  • Requestor’s telephone number
  • Requestor’s legal signature

The requestor may mail the written request to:

Department of Health and Senior Services
Attn: Lani De La Garza, Deputy Chief
Bureau of Vital Records
930 Wildwood Drive
Jefferson City, MO 65109

Once the written request for a death certificate is received, one blank death certificate and instructions for completing the certificate will be mailed to the requestor. Following the registration of the death certificate, certified copies of the death certificate may be obtained.

Presumptive Deaths

In accordance with 456.035, RSMo, and 490.620, RSMo, when a person who shall have resided in this state goes from and does not return to this state for a period five (5) successive years, he or shall be presumed to be dead and pursuant to 193.145, RSMo, when a death is presumed to have occurred within the state, but the body cannot be located, a death certificate can be prepared upon receipt of a certified court order. The certified court order must instruct the Bureau of Vital Records to establish a certificate of death that includes the information below. The list below does not include all items on the death certificate. 19 CSR 10-10.050 lists the contents of Missouri’s death certificate and the court order may include items listed if it chooses to do so (such as decedent’s education, occupation, and industry, etc.)

At a minimum, the court order should include:

  • Decedent’s legal name (first, middle, last and suffix, if any);
  • Decedent’s name prior to first marriage, if applicable;
  • Date of death as determined from evidence presented;
  • City, county and place of death as determined from the evidence presented;
  • Decedent’s date of live birth, city and state or country of live birth, race(s), ethnicity, sex, social security number, and parent(s) name(s);
  • Decedent’s address, including street address, city, county, state, and zip code at time of death;
  • Name, prior to first marriage, of surviving spouse (if any); and
  • The information necessary to complete the medical certification, including the cause and manner of death.

If the death occurred from an injury, information on how and when the injury occurred, as determined from the evidence presented, should be included. If such information is unknown, the court order shall indicate such.

Upon receipt of a certified court order, the Bureau of Vital Records will prepare and register the death certificate based on the information in the court order. The death certificate will show the date of the court order and the name of the court issuing the order. The record will be marked “Presumptive” and the court order will be placed in a sealed file.

Fetal Death

Registering a Missouri Report of Spontaneous Fetal Death

A fetal death is defined as a non-induced death prior to the complete expulsion or extraction from its mother of a fetus, irrespective of the duration of pregnancy, the death is indicated by fact that after such expulsion or extraction the fetus does not breathe or show any other evidence of life such as beating of the heart, pulsation of the umbilical cord, or definite movement of voluntary muscles.

Each spontaneous fetal death of twenty (20) completed weeks gestation or more, calculated from the date of last normal menstrual period began to the date of delivery, or a weight of three hundred fifty (350) grams or more which occurs in Missouri shall be reported within seven (7) days after delivery.

When a dead fetus is delivered in an institution, the person in charge of the institution or his or her designated representative shall prepare and file the report.

When a dead fetus is delivered outside an institution, the physician in attendance at or immediately after delivery shall prepare and file the report.

When a spontaneous fetal death required to be reported by this section occurs without medical attendance at or immediately after the delivery or when inquiry is required by the medical examiner or coroner, the medical examiner or coroner shall investigate the cause of spontaneous fetal death and shall prepare and file the report within seven days.

When a spontaneous fetal death occurs in a moving conveyance and the fetus is first removed from the conveyance in this state or when a dead fetus is found in this state and the place of the spontaneous fetal death is unknown, the spontaneous fetal death shall be reported in this state. The place where the fetus was first removed from the conveyance or the dead fetus was found shall be considered the place of the spontaneous fetal death.

In Missouri, when a fetal death occurs either in an institution or without any medical attendance, the fetal death record will be registered electronically in MoEVR by either the person in charge of the institution or, for those with no medical attendance, by a medical examiner/coroner. If you need MoEVR access or assistance, email MoEVR support at MoEVRsupport@health.mo.gov or call 573-751-6387. If the fetal death occurred with medical attendance, but outside of an institution, contact the Missouri Bureau of Vital Records at 573-751-6387 for more information on how to record the fetal death record.

Retention of Records and Information

Retention of Records and Information Used to Create a Vital Record

Every person in charge of an institution shall keep a record of data concerning each person admitted or confined to such institution as may be required for the filing of a certificate of birth and death or report of spontaneous fetal death which occurs in the institution. The record shall be made from information provided by the person being admitted or confined, but when it cannot be so obtained, the information shall be obtained from relatives or other persons acquainted with the facts. The name and address of the person providing the information shall be a part of the record.

When a dead body or dead fetus is released or disposed of by an institution, the person in charge of the institution shall keep a record showing the name of the decedent, date of death, name and address of the person to whom the body or fetus is released, and the date of removal from the institution. If final disposition is made by the institution, the date, place, and manner of disposition shall also be recorded.

A funeral director, embalmer, sexton, or other person who removes from the place of death, transports, or makes final disposition of a dead body or fetus, in addition to filing any certificate or other report required by sections 193.005 to 193.325, or regulations promulgated hereunder, shall keep a record which shall identify the body, and such information pertaining to his receipt, removal, delivery, burial, or cremation of such body as may be required by regulations adopted by the department.

Records maintained under this section shall be retained for a period of not less than five years and shall be made available for inspection by the state registrar or his designee upon demand.

Any person having knowledge of the facts shall furnish such information as he may possess regarding any birth, death, spontaneous fetal death, marriage, or dissolution of marriage upon demand of the state registrar.