Logo of the West Virginia Health Statistics CenterWest Virginia

Health Statistics Center

Providing Statistical Information for Informed Decisions

Statistics & Trivia
Special Data Requests
About the HSC
Contact Information

Vital Registration
Room 165 350 Capitol Street
Charleston, WV 25301-3701



The HSC offices are located in the Diamond Building at 350 Capitol Street in downtown Charleston. Below are two maps in PDF format showing the Diamond Building location. Map 1 is of the general Charleston area and Map 2 is more detailed of the downtown area and gives street traffic flow (one way/two way) designations.

Map 1 Map 2

Vital Registration Forms

Certificate Request Forms
Form Name Purpose Formats
Birth Form  Request state certified copy of a Birth Certificate  PDF, HTML
Death Form  Request a state certified copy of a Death Certificate  PDF, HTML
Marriage Form  Request a state certified copy of a Marriage Certificate  PDF, HTML
Heirloom Form  Request an Heirloom certificate which comes with one state certified copy of a birth certificate  PDF

Corrections/Amendments Forms
Form Name Purpose Formats
Affidavit to Correct Birth Used to Correct Mistakes on an Adult's Birth Certificate PDF, DOC
Affidavit to Correct a Minor Child's Birth Used to Correct Mistakes on Children's Birth Certificates (under age of 18) PDF,DOC
Affidavit to Correct Death Used to Correct mistakes on the Non-medical section of a Death Certificate PDF
Other Forms
Form Name Purpose Formats
Supply Request Form (For Hospitals, Nursing Homes, County Clerks, etc.)Request Supplies from Vital Registration PDF
Hospital Report of Births and Deaths Reports all births and deaths that occur in a facility per month to Vital Registration PDF
Permission Slip Form Used to by parents to grant permission to another person to obtain a copy of their child's birth certificate. PDF

Page was last updated on Friday, October 31, 2008 8:31 AM

The Health Statistics Center is a Division of:
The West Virginia Department of Health and Human Resources DHHR
Bureau for Public Health BPH
Office of Epidemiology and Health Promotion OEHP

If you have questions or comments about the HSC, please send them to: Health Statistics Center at "dhhrvitalreg@wv.gov"

This page was last updated 1/9/2009.