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Pre-register a death online

Fill in our online form below with the necessary details and we'll contact you to make an appointment to register the death once we've received all necessary medical paperwork.

* Indicates mandatory fields

Date of death:

First names and surname of deceased at time of death - include any other names they were known by during lifetime:

Maiden surname if deceased was a married woman:

Place of death - full address with postcode including the name of nursing home (if applicable) - if place of death was an ambulance or vehicle locality of vehicle at time of death and intended destination (eg Reading Road, Winnersh on way to Royal Berkshire Hospital):

Date of birth of deceased:

Place of birth of deceased - town and county / London borough or country of birth if born outside UK:

Marital status of deceased:

Most recent occupation of deceased - add retired if retired:

First names and surname of deceased's spouse/civil partner:

Date of birth of deceased's spouse/civil partner if they are still alive:

Occupation of deceased's spouse/civil partner:

Please fill the usual address of deceased.

Address Line 1

Address Line 2

Town/City

Postcode

NHS number of deceased if known:

Name and address of Deceased’s GP surgery (if known):

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Pre-register a death online

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