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Death Certificate Request Form

Accept death certificate requests online, capturing the deceased’s details, number of copies, and requester relationship in one clear form.

Description

The Death Certificate Request Form gives funeral directors a straightforward, sensitive way to handle requests for official copies. It captures the deceased’s full legal name, date and place of death, and the number of copies needed, so your team can process each request accurately the first time.

Fields for the requester’s relationship to the deceased, with a space to specify, and a mailing address ensure certificates reach the right person in the right way. Contact details and a digital signature confirm the request and keep everything documented for your records.

Managing requests through one structured form spares grieving families extra hassle. Sign up for a free Fun Forms account to customize the fields and embed this request form on your website.

Form fields

Everything the Death Certificate Request Form above collects — 10 fields, so you can see exactly what it captures before you make it your own.

Request a Death Certificate

  • Deceased’s Full Legal Name

    Name Icon
    Name

  • Date of Death

    Date Icon
    Date

  • Place of Death (City & State)

    Short Answer Icon
    Short Answer

  • Number of Copies Requested

    Short Answer Icon
    Short Answer

  • Relationship to the Deceased

    Short Answer Icon
    Short Answer

  • Please specify relationship:

    Short Answer Icon
    Short Answer

  • Mailing Address

    Short Answer Icon
    Short Answer

  • Your Email

    Email Icon
    Email

  • Phone Number (in case of questions)

    Telephone Icon
    Telephone

  • Digital Signature

    Short Answer Icon
    Short Answer
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Template FAQs

Common questions about the Death Certificate Request Form — what it captures, when to use it, and how to make it your own.

What is a death certificate request form?

A death certificate request form is an online form used to request official copies of a death certificate. It captures the deceased’s details, the number of copies needed, the requester’s relationship, and a delivery address, so funeral directors can process each request accurately and send certificates to the right person.

Why ask for the relationship to the deceased?

Recording the requester’s relationship to the deceased, with a space to specify, helps confirm they are entitled to request the certificate. It supports proper handling of sensitive records and ensures your team follows the correct process, giving families reassurance that copies are only released to those with a legitimate connection.

How many copies can be requested?

The form includes a field for the number of copies requested, so families can order exactly what they need. Multiple certified copies are often required to settle estates, close accounts, and handle legal matters, and capturing the quantity upfront means your team can fulfill the whole request in one go.

Where are certificates sent?

A mailing address field ensures certificates are posted to the correct location, while contact details allow your team to follow up with any questions. Collecting the delivery address with the request means copies reach the right person without delay, sparing families the frustration of chasing missing documents at a difficult time.

What is the digital signature for?

The digital signature confirms that the person submitting the request is who they say they are and that the details provided are accurate. It gives your team a documented record for each request, supporting the careful handling that official records like death certificates rightly require at every stage.

Is the death certificate request form free?

Yes, this death certificate request form is completely free, and you can customize the fields to match your process, embed it on your website, and go live with no coding required. Just create a free Fun Forms account to handle certificate requests online.

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