Order Death Certificates

Certificate Information

Quantity (Certificates cost $20.00 each)

Delivery Preferences

Mailing Information (The certificate will be mailed here upon payment)

If you do not provide a name and address the certificate cannot be mailed.

Notes or Comments Regarding Your Order

Please note: If you plan on purchasing this certificate with an electronic check (not a debit or credit card), there will be a two week waiting period to verify funds.


Picking Up An Order?

If you complete this order form and request to pick up your certificate(s) instead of having them shipped, you can retrieve them the next day at the Lewis County Public Health office here:

360 NW North Street
Chehalis WA 98532

* (Closed for lunch between 12:30 – 1:30)

If you are having any trouble with this order form, please contact us at:
(360) 740-1223