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