Washington State Department of Health Vital Statistic Form

Certificate of Dissolution, Declaration of Invalidity of Marriage or Legal Separation

The Washington State Department of Health is responsible for collecting vital records information for the State of Washington. Dissolutions of Marriage (divorce) and legal separations are reported to the Department of Health by way of a vital statistics form. The primary purpose of the reporting is to allow the state to track divorce trends.

The vital statistics form is mandatory and must be filed along with the petition for dissolution of marriage, registered domestic partnership or legal separation. The clerk of court is responsible for obtaining the completed vital statistics form and submitting it to the Department of Health.

How to obtain the form:

You can obtain the vital statistics form by requesting same from the Washington State Department of Health or from the Clerk of Court at the time of filing the petition with the court. At present, there is no way to obtain the vital statistics form online from the Clerk of Court or Department of Health.

If you use Washington Divorce Online to prepare your case, the vital statistics form is provided to you already filled out along with your attorney prepared case documents and case completion instructions.

You may register with Washington Divorce Online and then return to this page to download the form.

Access the Form Online:

Complete the information below to access the online vital statistics form.

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