Filling out the cause of death form

How to fill out a cause of death form.

Reportable and reviewable deaths

A 'reportable' death includes one resulting from a fracture, head injury, medical procedure, violence or unnatural causes.

Contact the Coroners Court of Victoria(opens in a new window) if you need to report a death.

Sex of the person who died

Enter the person’s anatomical sex at time of death. For example, if the person has undergone male to female gender reassignment surgery, enter ‘Female’.

Date of death

Doctors must provide an accurate date of death. The Department of Health specifies that all registered nurses and paramedics are eligible to pronounce and record the time and date of death, which certifying medical practitioners must acknowledge.

The date of death must be the first date declared by the registered nurse, paramedic or medical practitioner. If the deceased died at home, then the most accurate time should be assessed by the certifying medical practitioner.

Cause of death

The Australian Bureau of Statistics provides an information paper and quick reference guide for Cause of Death Certification(opens in a new window).

  • Specify the disease, injury or condition which led directly to the death, not only the mode of dying such as heart or respiratory failure.
  • Very short causes of death are acceptable if they are logical.
  • If the direct cause of death as described in "Cause of Death" was due to, or arose as a consequence of another disease, injury or condition, report this in "Antecedent causes".
  • Where cause of death can be ambiguous, always provide an antecedent cause.
  • Any kind of haemorrhage or fracture should always have an antecedent cause. An antecedent cause for fracture could be osteoporosis or for an intracerebral haemorrhage it might be hypertension.
  • Include only the relevant and important cause of death facts. The causes of death are combined with the deceased’s identity and family information to create the death certificate.

Example 1

Disease or condition and duration before death
Disease or conditionDuration
Myocardial infarction and arrest2 hours
Hypertensive cardiomyopathy5 years
Hypertension50 years

Example 2

Disease or condition and duration before death
Disease or conditionDuration
Infection (source and site of the infection and organism if known)3 weeks
Cancer (site or type of tumor e.g.: right upper lobe lung)5 years
Diabetes mellitus (e.g.: type 1 or type 2)10 years

Antecedent causes

List the final event first. Contributing events should then be listed in chronological order backwards from date of death.

Other significant conditions

Provide details of any other significant condition(s) contributing to the death but not related to the disease, injury or condition causing it.

Sibling information

Include legally adopted siblings, step brothers and step sisters.

Perinatal deaths

  • Perinatal deaths don’t need a sequence of events. Instead, list the main condition of the infant and the mother.
  • Provide detailed information about the duration, maternity and any recent surgeries; this information is valuable to the ABS.

Next steps

Edit a saved draft

Submit the form to BDM

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