Specialist Mortuary Services

Mortuary Preparation Authorisation
I certify that I,
Funeral Director Details (or person submitting this request)

First NameLast Name
Your Business Name (Funeral Directors)
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: 0000 00 0000.
am the appointed funeral director or I am the person with the legal authority to authorise care (Senior next-of-kin) of:
I hereby appoint Specialist Mortuary Services (herein named SMS) to carry out the level of mortuary care I specify. It is agreed that embalming services are performed by a qualified embalmer. I understand that SMS will advise the level of care needed if it is beyond the scope I request, but that I am required to make the final decision regarding what care is to be provided I agree to communicate in a timely manner so that SMS can complete the required preparation in a reasonable time frame.

I also understand that SMS cannot begin preparing my client's deceased without an authorised signature on this form.

I give permission for SMS to take before and after photos when necessary, knowing that these images will be held in confidence. Such images will not be digitally transmitted without express permission of the authorising funeral director/senior next-of-kin.
First Name (Deceased)
Middle Name (Deceased)
If applicable
Last Name (Deceased)
Date of BIRTH

DayMonthYear
Date of DEATH

DayMonthYear
Cause of Death Paperwork
Please upload MCOD or CCV Release here

Cancelof
Signature of authorising person

Mortuary Service Requirement Details
When do you need this work completed by?

DayMonthYear
When will you be collecting your person?

DayMonthYear
If you do not do not have a set date for collection, please provide some details about an anticipated timeframe. Please note that a storage fee takes effect after 7 days (refer to our price list for details).

Mortuary Preparation Authorisation