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Autopsy_ Consent to

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					                                  Consent to Autopsy

State of _________________________
County of _________________________

________________________ hereby consents to the performance of an autopsy on
________________________, the DECEASED, by ____________________________. The
relationship of _________________________ to the deceased is __________________.

Dated: ______________________


______________________________
______________________________

Sworn to and subscribed before me on the date stated above.

______________________________
Notary Public
My commission expires:
                                    Consent to Autopsy
                                           Review List

This review list is provided to inform you about the document in question and assist you in its
preparation. There are a number of reasons for an autopsy; this form provides one’s official
consent to that by a relative or person with legal standing regarding the individual upon who the
autopsy is conducted.

After the death of a person close to you, or over whom you have legal responsibilities, attending to
this document at the same time you do others can save on your emotional wear and tear under
the immediately stressful circumstances following death. Getting this document notarized at that
time can contribute to a lessening of stress, should it prove to be necessary to have a Consent to
Autopsy done for the authorities.

				
DOCUMENT INFO
Description: Health and Care