DISTRICT TWELVE MEDICAL EXAMINER
MANATEE COUNTY FACILITY
CONSENT FOR RELEASE OF BODY OF DECEASED
THE MEDICAL EXAMINER OF DISTRICT TWELVE IS HEREBY GIVEN PERMISSION TO DELIVER THE BODY
(Name of Decedent)
TO: Going Home Cremation Services 941-320-1179
To undersigned represents:
To the best of my knowledge, the deceased during his lifetime made no indications contrary to the permission I have given for disposition of the body of the deceased.
To the best of my knowledge, there is no opposition to the permission I have given for disposition of the body of the deceased by any person who precedes me in legal priority for consent.
I hereby release the Manatee County Medical Examiner Facility and the District Twelve medical Examiner, there agents, employees or representatives, from any liability which may arise as a result of the release of the above named decedent to me
PRIORITY OF CONSENT:
Please fax back: 941-320-1179 _ Med.Exam
Or: 727-934-1529 _ Funeral Home