Going Home Cremation Services 101 Old East Lake Road Tarpon Springs, FL 34688 Ph. 239-233-6122 Fax 727-279-4679 Authorization to Release Body District 21/ Lee Counties (Print: Next of Kin Name) , (Relationship) (Name of Decease) Hereby authorize the District 21 Medical Examiner’s office To Release the Body to (Funeral Home/Cremation Service) (Signature of Next of Kin) Date Δ