Going Home Cremation Services

    1120 S Pinellas Bayway

    Tierre Verde, FL 33716

    Ph. 239-233-6122   Fax 727-934-1529

    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