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.
am the appointed funeral director or I am the person with the legal authority to authorise care (Senior next-of-kin) of:
First Name (Deceased)*
Middle Name (Deceased)
If applicable
Last Name (Deceased)*
Date of BIRTH*

DayMonthYear
Date of DEATH*

DayMonthYear
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.
Cause of Death Paperwork*

I will upload a copy of the MCOD (Medical Cause of Death) formI will upload a copy of the Coroners Release FormThe Coroners Release Form will will be delivered with the deceasedThe MCOD (Medical Cause of Death) will be delivered with the deceasedI will send through these documents at a later stage - (please note that mortuary prep cannot be carried out before sighting these documents)
Please upload MCOD or CCV Release here

Cancelof
Signature of authorising person*

Clear

Do you have your preparation requirements ready?
PREPARATION DETAILS

YES - I have all preparation details on handNO - Preparation details to be confirmed
IF you answered NO - please provide additional details

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).

Please press the SUBMIT button below to complete your request.
Should be Empty:

Mortuary Preparation Authorisation

Do you have your preparation requirements ready?

Mortuary Service Requirement Details