MoEVR Missouri DHSS

The purpose of the Missouri Electronic Vital Records (MoEVR) system is to support the registration of Missouri vital events for the Missouri Department of Health and Senior Services and other users such as funeral directors, attending physicians, medical examiners, and birthing facilities. This system may be used only for the purpose for which it is provided. Any attempt to file fraudulent certificates of live birth, death, or reports of fetal death is punishable in accordance with Missouri statutes.

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Need MoEVR access or assistance? 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 (Section 193.085, 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.

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.

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.

Out of Hospital/Institution Births or Home Births

A certificate of live birth for each birth occurring in Missouri must be filed within five (5) days after the date of birth (Section 193.085, RSMo). 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 and will need to contact this office for further instructions at 573-751-6378.

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.
  2. Any other person in attendance at or immediately after the birth. (Certified Nurse Midwife, Certified Professional Midwife, Certified Midwife, or Other Midwife.)
  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

To request a certificate of live birth or additional copies and further details about correctly documenting an out of facility birth/home birth, please contact the Bureau of Vital Records at 573-751-6378.

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 first page)

Must be signed by two other individuals not on the face of the certificate in the presence of a notary public. Attendant may sign if he/she is not the certifier. If the certifier on the certificate is a licensed physician (MD, DO) or accredited midwife (CNM, CPM, 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.

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: Please 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

Please 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 that the mother was
    • pregnant during the time of birth to which is being sworn.
  2. Evidence of the mother’s residence in this state at the time of the birth
    Evidence documents must include mother’s name and address and be from month 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 Physician (MD, DO)
All out of facility births require a notarization of the certificate of live birth to properly document the birth. However, a licensed physician is not required to submit proof of pregnancy and residency with the notarized certificate of live birth. Proof of current and valid licensure is required.
Accredited Midwife (CNM, CPM, CM)
All out of facility births require a notarization of the certificate of live birth to properly document the birth. However, a Certified Nurse Midwife (CNM), Certified Professional Midwife (CPM), or Certified Midwife (CM) is not required to submit proof of pregnancy and residency with the notarized certificate of live birth. A lay midwife would not qualify for this exception. Proof of current and valid licensure is required.

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 report of live birth.  If the State Registrar does not register the delayed 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.

Mothers in a Same-Sex Marriage

On October 3, 2014, the Jackson County Circuit Court issued an order in Barrier v. Vasterling, Case No. 1416-CV03892, holding that Missouri must recognize marriages lawfully entered into in jurisdictions where same-sex marriage is lawful. On Monday, October 6, 2014, the Missouri Attorney General announced that the state would not appeal the ruling. Accordingly, women in same-sex marriages lawfully entered into in jurisdictions where same-sex marriage is lawful, who give birth in Missouri, may choose to have their spouse listed as the baby’s other parent on the birth certificate.

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.

Certifying Cause of Death

HB 618 allows physician assistants, assistant physicians and advanced practice registered nurses in addition to physicians and coroners/medical examiners to medically certify death certificates.

This bill requires DHSS to notify all physicians and the professions noted above of the requirements regarding use of MoEVR. Letters are being drafted to these medical professions and the MO Funeral Directors Association concerning the implementation of this legislation. DHSS expects for the notification to all professionals noted in HB 618 to be sent by the end of December 2015. DHSS is working with Missouri State Medical Association, Missouri Association of Osteopathic Physicians and Surgeons, Missouri Hospital Association, Missouri Professional Registration, Missouri Chapter - American College of Cardiology, Missouri Academy of Physician Assistants, Missouri Nurses Association, Association of Missouri’s Nurse Practitioners, Missouri Coroner’s and Medical Examiner’s Association, Missouri Funeral Directors and Embalmers Association to notify the above referenced professions of the changes outlined in HB 618.

The bill allows the medical certifier to designate any other person to enter the medical certification information into MoEVR 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. The language does not allow someone other than the certifier to electronically certify the record. If a medical certifier chooses to designate someone to enter, into MOEVR, the medical certification information on the physician’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 processing of the form to occur.

DHSS is also required to create a working group to evaluate the electronic vital records system and develop recommendations to improve the efficiency and usability of the system by January 1, 2016.

A brief presentation highlights why Vital Records are collected and how the information collected is utilized in research and in allocating funding for prevention educational efforts.

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 death certificate. 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 and telephone number of physician or medical certifier/coroner
  • Name of requestor and relationship to decedent
  • Requestor’s mailing address
  • Requestor’s telephone number

The requestor may mail the written request to:

Department of Health and Senior Services
Attn: BVR Deputy Bureau Chief
Bureau of Vital Records
PO Box 570
Jefferson City, MO 65102-0570

Once the written request for a death certificate is received, one death certificate and instructions for completing the certificate will be mailed to the requestor.

Presumptive Deaths

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 court order.  The 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.)

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.  If such information is unknown, the order shall indicate such.

Upon receipt of a certified court order, the Bureau of Vital Records will prepare and register the death 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.

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.

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.