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Authorization to Embalm Mobile App

The Authorization to Embalm mobile app allows the signer who represents the deceased, to declare legal authority to authorize embalming or refuse to give permission to embalm the named deceased individual. Before you can get started you will need to download the GoCanvas Utility Pack App from the Android Market or GoCanvas Plus from the Apple App Store (For BlackBerry Barcode scanning is only available on devices that are running BlackBerry OS 6.0 and above i.e. BB Torch)

  • Lendlease
  • The Cooperative
  • PG&E
  • oxy
  • Red Bull
  • Mirvac

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Take a peek inside the Authorization to Embalm Mobile App

Included Features

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Included Fields

Customize to add, remove, or edit any of the fields below.

  • Ico statictext

    AUTHORIZATION TO EMBALM AT FUNERAL ESTABLISHMENT OR OTHER LOCATION

  • Ico textbox

    Name of Licensed Funeral Establishment

  • Ico textbox

    Name of Deceased

  • Ico date

    Date of Death

  • Ico statictext

    The undersigned, understanding that embalming is not required by law except in certain special ca...

  • Ico date

    Date Signed

  • Ico signature

    Signature of next-of-kin or Person Responsible for making arrangements for final disposition

  • Ico statictext

    NOTE: Mortuary Students may only participate in embalming if permission is in writing and in the ...

  • Ico statictext

    If no authorization can be obtained, complete the following:

  • Ico textbox

    I hereby acknowledge that (Name of Establishment)

  • Ico statictext

    period of at least three hours to obtain authorization to embalm the deceased.

  • Ico textbox

    Times contact with family attempted:

  • Ico signature

    Signature

  • Ico textbox

    License # of Embalmer

  • Ico statictext

    The undersigned, who represents the deceased, hereby declares that having the legal authority to ...

  • Ico signature

    Signature

  • Ico date

    Date

  • Ico statictext

    If Authorization for embalming is oral, complete the following:

  • Ico textbox

    Location of embalming disclosure was discussed with next-of-kin or person responsible for making ...

  • Ico textbox

    Relationship to Deceased

  • Ico time

    Time

  • Ico date

    Date

  • Ico textbox

    Received by

  • ...and More!

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