Laclede County Health

                                                            "Protecting Our Community"


405 Harwood Ave.

Lebanon, Missouri



ARE YOU...


1. Needing a copy of either a BIRTH or DEATH certificate?


2. Wanting to send this form by MAIL. Not in person?


**This form needs to be notarized to allow certificates to be released.

Please call our office (417-532-2134) if you have any questions! Thank you!

You may mail this form to the Jefferson City office with the address listed at the top of the form, OR you may mail it directly to our office here at:

_____________________________________

Laclede County Health Department

405 Harwood Ave

Lebanon, MO 65536

Birth & Death Certificate Applications

ARE YOU...


1. Needing a copy of either a BIRTH or DEATH certificate?


2. Going to personally deliver this form to our office at 405 Harwood Ave, Lebanon, MO?

OR