Upload forms directly to the West Virginia e-Directive Registry

 

Forms can be submitted to the e-Directive Registry by fax at 844-616-1415; by mail at 64 Medical Center Drive, PO Box 9022 Health Sciences North, Morgantown, WV 26506-9022; or by e-mail at registryinfo@hsc.wvu.edu.

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 faxing to 844-616-1415.  Please note, these forms will be released to healthcare providers Monday-Friday from 8:00am to 4:00pm EST.