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.

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 healthcare provider requesting forms off of the registry, please complete a RELEASE OF INFORMATION FOR HEALTHCARE PROVIDERS then send to the e-Directive Registry by UPLOADING directly below or faxing to 844-616-1415.  Please note, these forms will be released to healthcare providers Monday-Friday from 8:00am to 8:00pm EST.