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
OF:
(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:
- 1. Spouse
- 2. Adult Son or Daughter
- 3. Wither Parent of Decedent
- 4. Adult Brother or Sister
- 5. Other Blood Relatives
- 6. Personal Representative of Decedent’s Estate
- 7. Judicially Appointed Guardian
Please fax back: 941-320-1179 _ Med.Exam
Or: 727-934-1529 _ Funeral Home