Arrange Cremation Step 1 of 8 0% We are so sorry to hear about your loss.You can begin making the arrangements by simply filling out this form and then we will call you to go over it. Or give us a call at 817-420-9898 and we can go over it together. While we are on the phone with you, we will walk you through the various options and costs related. Please select the services that you need below.Weight Under 275lbs 276lbs - 400lbs 400lbs + Number of Death Certificates Needed Do you need a Witness or I.D. Viewing? Yes No Do you need to ship the ashes? Yes No If your loved one is located outside of Dallas/Fort Worth, please tell us where below. Authorization for Cremation & DispositionTHIS IS A LEGAL DOCUMENT. IT CONTAINS IMPORTANT PROVISIONS CONCERNING CREMATION. CREMATION IS IRREVERSIBLE AND FINAL. READ THIS DOCUMENT CAREFULLY BEFORE SIGNING!I, THE UNDERSIGNED, CERTIFY, WARRANT AND REPRESENT THAT I HAVE THE FULL LEGAL RIGHT AND AUTHORITY TO AUTHORIZE THE CREMATORY, PROCESSING AND DISPOSITION OF THE REMAINS OF (HEREINAFTER REFERRED TO AS THE DECEASED).I HEREBY REQUEST AND AUTHORIZE COMMUNITY MORTUARY SERVICES TO TAKE POSSESSION OF AND MAKE ARRANGMENTS FOR THE CREMATION OF THE REMAINS OF THE DECEASEDI AUTHORIZE THE CREMATORY TO RETURN THE CREMATED REMAINS OF THE DECEASEDI AUTHORIZE THE CREMATORY TO SHIP THE CREMATED REMAINS (BY U.S. MAIL IN A DESTRUCTABLE CONTAINER) TO:COMPLETE ADDRESS THE CREMATION, PROCESSING, AND DISPOSITION OF THE REMAINS OF THE DECEASED AUTHORIZED HEREIN SHALL BE PERFORMED IN ACCORDANCE WITH ALL GOVERNING LAWS, THE RULES REGULATIONS OF THE CREMATORY AND COMMUNITY MORTUARY SERVICES, AND THE FOLLOWING TERMS AND CONDITIONS:IT IS THE POLICY OF THE CREMATORY TO REQUIRE THE REMAINS OF THE DECEASED TO BE PLACED IN SOME TYPE OF MINUMUM CONTAINER. IF THE DECEASED IS NOT IN A CONTAINER WHEN IT REACHES THE CREMATORY, THEN A MINIMUM CONTAINER IS USED.PACEMAKERS MAY CREATE A HAZARD WHEN PLACED IN A CREMATION CHAMBER. I UNDERSTAND THAT FAILURE ON MY PART TO NOTIFY THE CREMATORY OF SUCH IMPLANT COULD RESULT IN DAMAGE TO CREMATORY WORKERS OR EQUIPMENT AND I WILL BE HELD LIABLE.DECEASED DOES DOES NOT CONTAIN ANY TYPE OF IMPLANTED MECHANICAL OR RADIOACTIVE DEVICE.CERTAIN ITEMS, INCLUDING BUT NOT LIMITED TO BODY PROSTHESES, DENTURES, DENTAL BRIDGEWORK, DENTAL FILLINGS, JEWELRY, AND OTHER PERSONAL ARTICLES ACCOMPANYING THE REMAINS OF THE DECEASED, MAY BE DESTROYED DURING THE CREMATION PROCESS. I FURTHER AUTHORIZE THAT IF ANY ITEMS OTHER THAN THE CREMATED REMAINS OF THE DECEASED ARE RECOVERED FROM THE CREMATION CHAMBER, THEY MAY BE SEPARATED FROM THE CREMATED REMAINS OF THE DECEASED AND DISPOSED OF BY THE CREMATORY.FOLLOWING CREMATION, THE CREMATED REMAINS OF THE DECEASED CONSISTING PRIMARILY OF BONE FRAGMENTS WILL BE MECHANICALLY PULVERIZED TO AN UNIDENTIFIABLE CONSISTENCY PRIOR TO PLACEMENT IN AN URN OR OTHER CONTAINER.UNLESS AN URN OR CONTAINER SUITABLE FOR SHIPMENT IS PROVIDED, THE CREMATORY WILL PLACE THE CREMATED REMAINS OF THE DECEASED IN A TEMPORARY CONTAINER MADE OF PLASTIC AND IN A CARDBOARD MAILER WHICH IS DESTRUCTIBLE AND WILL NOT BE HELD LIABLE FOR ANY DAMAGES THAT MIGHT OCCUR DURING SHIPMENT.IN THE EVENT THIS CONTAINER OR PROVIDED URN IS INSUFFICIENT TO ACCOMMODATE ALL OF THE CREMATED REMAINS OF THE DECEASED, ANY EXCESS CREMATED REMAINS WILL BE PLACED IN A SECONDARY CONTAINER AND RETURNED TO COMMUNITY MORTUARY SERVICES TOGETHER WITH PRIMARY CONTAINER OR URN.I UNDERSTAND AND ACKNOWLEDGE THAT EVEN WITH THE EXERCISE OF REASONABLE CARE AND THE USE OF THE CREMATORY'S BEST EFFORTS, IT IS NOT POSSIBLE TO RECOVER ALL PARTICLES OF CREMATED REMAINS OF THE DECEASED AND THAT SOME PARTICLES MAY INADVERTENTLY BECOME COMINGLED WITH PARTICLES OF OTHER CREMATED REMAINS REMAINING IN THE CREMATION CHAMBER AND/OR DEVICES UTILIZED TO PROCESS THE CREMATED REMAINS.I AGREE TO INDEMNIFY RELEASE AND HOLD THE CREMATORY, COMMUNITY MORTUARY SERVICES, THEIR AFFILIATES, AGENTS, EMPLOYEES, AND ASSIGNS HARMLESS FROM ANY AND ALL LOSS, DAMAGES LIABILITY, OR CAUSES OF ACTION (INCLUDING ATTORNEYS FEES AND LITIGATION EXPENSES) IN CONNECTION WITH THE CREMATION AND DISPOSITION OF THE CREMATED REMAINS OF THE DECEASED, AS AUTHORIZED HEREIN, OR MY FAILURE TO CORRECTLY IDENTIFY THE REMAINS OF THE DECEASED, DISCLOSE THE PRESENCE OF ANY IMPLANTED OR MECHANICAL RADIOACTIVE DEVICES OR TAKE POSSESSION OF OR MAKE PERMANENT ARRANGEMENTS FOR THE DISPOSITION OF SUCH REMAINS.SIGNATURE OF PERSON(S) AUTHORIZING CREMATION & DISPOSITIONI WARRANT THAT ALL REPRESENTATIONS AND STATEMENTS MADE HEREIN ARE TRUE AND CORRECT AND THAT I HAVE READ AND UNDERSTAND THE PROVISIONS CONTAINED IN THIS DOCUMENT.Name First Last Email SignatureRelationship Date MM slash DD slash YYYY SignatureRelationship Date MM slash DD slash YYYY SignatureRelationship Date MM slash DD slash YYYY CERTIFICATE OF DEATHINFORMANT'S INFORMATIONFirst Name Last Name Phone Number Email Complete Mailing Address Relationship DECEDENT'S INFORMATION Decedent's Name Place of Birth (City and State) Sex Age DOB SS# Complete Mailing Address Inside City Limits Y/N Marital StatusMarriedDivorcedWidowedNever MarriedSurviving Spouse's Name Education LevelNo GEDGED or High SchoolSome CollegeCollege DegreeEver in Armed Forces Y/N Military BranchIf ApplicableArmyNavyCoast GuardMarine CorpsAir ForceSpace ForceIf ApplicableEver a Police Officer Y/N Occupation Industry Father's Name Mother's Name Maiden Name Method of DispositionCremationEntombmentRemoval from State Visual Identification AcknowledgementTHE UNDERSIGNED, HAVING VIEWED THE REMAINS, DOES HEREBY IDENTIFY THE SAME AS THEBODY OF AMPLE TIME HAS BEEN GIVEN THE UNDERSIGNED TO ASSURE PROPER IDENTIFICATION.THE UNDERSIGNED ASSUMES ALL LIABILITY FOR INCORRECT IDENTIFICATION AND DOES HEREBY AGREE TO INDEMNIFY, DEFEND AND HOLD COMMUNITY MORTUARY SERVICES, INCLUDING THEIR AGENTS AND EMPLOYEES, HARMLESS FROM ANY AND ALL CLAIMS, DAMAGES, LIABILITIES, AND COSTS (INCLUDING REASONABLE ATTORNEY'S FEES) WHICH MAY ARISE IF THIS IDENTIFICATION IS INACCURATE.SIGNATURE OF AUTHORIZED PERSONRELATIONSHIP TO DECEASED PRINTED NAME AND COMPLETE ADDRESS DATE, TIME AND PLACE SIGNED EMAIL If your loved one is at the Office of the Medical Examiner, please select their location below. If they are not, please select N/A. Dallas County Tarrant County N/A M.E. Case # This authorizes the Institute of Forensic Sciences, Dallas, Texas,to release the remains and the personal effects of to the Funeral Home or their agent. During the investigation by the Medical Examiners Office you may obtain information about the option of donating tissues for transplantation by contacting your funeral director or Transplant Services at 214-648-2609 or 800-433-6667.Signature of next-of-kinPrinted name/Telephone # Relationship of next-of-kin or other person legally entitled to control disposition of remains Date signed MM slash DD slash YYYY Date MM slash DD slash YYYY This authorizes the Office of Chief Medical Examiner of Tarrant County, Texas,to deliver the remains of to the funeral home. Please complete the funeral home information below: Complete Address City Phone # Fax # State Zip Authorization is also given to the above named funeral home, or its designated agents, to remove the said deceased to their place of business to care for, and prepare for disposition in accordance with professional standards.Funeral Home is authorized to receive valuables Yes No SignaturePrinted Name Relationship Note: Cash over $50.00 must be picked up in person by next-of-kin.EmailThis field is for validation purposes and should be left unchanged.