Upload forms directly to the West Virginia e-Directive Registry

 

You can submit your (or a patient’s) advance directive, do-not-resuscitate (DNR) card, or Physician Orders for Scope of Treatment (POST) form to the e-Directive registry below. Please fill in the requested information, select the scanned image or picture of the form you would like to submit, and click upload! Please call the Registry at 877.209.8086 for questions.  You can also submit forms by fax to 844-616-1415 or by mail to 64 Medical Center Drive, PO Box 9022 Health Sciences North, Morgantown, WV 26506-9022.

If your advance directive forms do not contain an Opt-In box giving permission for inclusion in the e-Directive Registry, download and complete the E-Directive Registry Opt-In form. The form must be completed, the Opt-In box INITIALED, and submitted with your advance directive forms.

If you are a health care provider requesting forms off of the registry, please complete a RELEASE OF INFORMATION FOR HEALTH CARE PROVIDERS then send to the e-Directive Registry by faxing to 844-616-1415.  Please note, these forms will be released to health care providers Monday-Friday from 8:00am to 4:00pm EST.