Effective April 1, 2023, Clark County Code 24.18.030 requires all Clark County deaths be reported to and receive authorization from the Clark County Medical Examiner’s Office prior to releasing the body for disposition, regardless of where the decedent lived or where disposition is to occur.

The disposition authorization process ensures the cause and manner of death identified on every death certificate is reviewed and verified. When a suspicious or accidental death is discovered before the body is buried or cremated, the Medical Examiner’s Office and, if appropriate, law enforcement can investigate the circumstances of the death and provide families with an accurate account of what happened to their loved one.

How the program works

The Clark County Medical Examiner’s Office reviews all deaths that occur in Clark County. Before a death certificate is certified, the Medical Examiner’s Office reviews each cause of death identified on the death certificate to verify that the cause (what the person died from) and manner (natural, homicide, suicide, accident or undetermined) do not indicate the need to assume jurisdiction. Deaths that fall within the jurisdiction of the Medical Examiner’s Office include accidental deaths, homicides and suicides. If an unnatural death is discovered before the body is buried or cremated, then law enforcement and the Medical Examiner’s Office can ensure an investigation is completed.

How to request a disposition authorization

The disposition authorization request process is to be completed by the funeral home of record. Requests for a disposition authorization review can be submitted via our online form or email.

If the funeral home of record changes following the approval of the disposition authorization, it is the responsibility of both funeral homes to notify the Medical Examiner's Office immediately to avoid errors in billing.

• If you were the initial funeral home that submitted the review but are no longer handling the disposition, notify the Medical Examiner's Office immediately upon the change to avoid your funeral home being responsible for the invoice.
• If you are the funeral home taking over the disposition from another funeral home, you MUST submit a Request for Disposition Review form, even if a disposition authorization number has already been assigned. Contact the Medical Examiner's Office immediately upon the change.

Possible delays when processing requests

The Medical Examiner's Office makes every effort to process and approve all disposition requests as efficiently as possible. However, requests may be delayed if information provided on the death certificates are incomplete or do not meet state guidelines.  To prevent a delay, please ensure all sections of the authorization form and death certificate are complete prior to submission to the Medical Examiner’s Office.

To avoid a delay in processing please ensure:

• An underlying disease process or etiology has been listed in sections 34/35 of the death certificate. For example: "pneumonia" is not acceptable and needs further clarification. "Cardiac arrest" and "respiratory failure" are mechanisms of death, not causes of death. An underlying disease process is needed.
• All non-natural causes of death, including fractures, must be reported to, and certified by, the Medical Examiner.
• Intracranial hemorrhages must be clarified with specific bleed site and etiology, or whether the bleed was "spontaneous" and hypertensive.
• Death certificates should meet the Washington State Department of Health (DOH) death certificate guidelines, available at the DOH website.