Cremation Authorization Form

Cremation Authorization Form
Cremation process is an irrevesible process. Please fill up the form carefully and let us know if you have any questions.
Contact Person
Name
First NameLast Name
Email
example@example.com
Phone Number
Address
Street Address
Street Address Line 2
CityState / Province
Postal / Zip Code
Name of Deceased
First NameLast Name
Gender
Date of Death
MonthDayYear
Date
Time of Death
Hour Minutes
AM/PM Option
Place of Death
Type of Cremation
Memorial serviceDirect cremation (without ceremony)Traditional serviceDonation to science
Type of Urn
Keepsake UrnBiodegradable UrnCompanion UrnInfant UrnTheme Urn
Authorization and Consent
1. I confirmed that the decedent's remains do not have a pacemaker or any implantable devices.
2. I understand that this process is irreversible.
3. I fully understand all the information provided in this authorization form.
4. I indemnify and hold harmless DEFG Funeral Home, its staff, and employees from any claims, demands, or suit of every kind, any damage due to implants, or negligence of the contact person.

Contact Person