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Cremation Authorization Form

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The State of Ohio requires that this Authorization Form be completed an signed prior to the cremation. Please read it carefully and ask us an questions you may have. Creamtion is an irreversible and final process. It is important that you understand the cremation process that is described in Section 9 of this Authorization Form prior to signing it. We want you to fully understand the information provided in this Authorization Form, so we will be pleased to answer any questions about the cremation process or the other information in this form.



THE AUTHORIZATION IS NOT A CONTRACT FOR CREMATION SERVICES. A SEPARATE CONTRACT OR CONTRACTS WILL BE REQUIRED TO PURCHASE THE SERVICES OF THE FUNERAL HOME AND/OR CREMATORY.




 
 

 
 
 
 

The Authorazing Agent authorizes the Funeral home and Crematory set forth below to carry out the directions and isntrucions of the Authorizing Agent contained in this Authorization.


 
 
 
 
 
 
 
 
 



Pacemakers, radioactive, silicon or other implants, mechanical devices or prostheses may create a hazardous condition when placed in the cremation chamber and subjected to heat. As Authorizing Agent, I have listed all of devices (including mechanical, prosthetic, implants, or materials) which may have been implanted in or attached to the Decedent.


 

The remains are to be cremated in a combustible casket or alternative container that is capable of being completely closed, is resistant to leakage or spillage, is sufficiently rigid to be handled easily, and provides protection for the health and safety of Rematory and Funeral Home personeel. The Crematory is authorized to inspect the casket or alternative container, including opening it if necessary. In the event that the casket or container does not meet the above requirements, the Crematory will notify the Authorizing Agent. Many caskets that are comprised primarily of combustible material also contain some exterior parts (decorative handles or rails) that are not combustible and taht may cause damage to the cremation equipment. As authorizing Agent, I authorize the Crematory, in its discretion, to remove and discard the non-combustible materials. I understand theat some crematories willn ot accept metal or fiberglass caskets. I further understand that the dcasket or alternative container will be consumed as part of the cremation process.


 

Under Ohio law, the remains of more than one decedent may not be simultaneously cremated in the same creamtion chamber unless the decedents to be cremated were related or were, anytime during the one-year period preceding their deaths, living in a common law marital relationship or cohabitating. Unless authorized on the reverse side, the Decedent's remains shall be individually cremated.


 

Witnessing a cremation ca be an emotional experience. Witnesses are assuming the risks involved and fully release the Funeral Home and Crematory from any liability. To the extent permitted by the Crematory, the persons listed below are authorized to be present at the cremation room prior to and during the cremation of the Decedent's remains and during the removal of the cremated remains from the creamtion chamber. If you desire witnesses, you must check Yes and list their names.



The cremation of the Decedent’s remains may take place before or after ceremonies to memorialize the Decedent. Cremation is performed to prepare the remains of the Decedent for final disposition. It is carried out by placing the Decedent's remains in the casket or alternative container, individually unless noted otherwise in Section 7 above. During the cremation process, it may be necessary to open the cremation chamber and reposition the remains of the Decedent in order to facilitate a complete and thorough cremation. Through the use of suitable fuel, the incineration of the container and its contents is accomplished and all substances are consumed or driven off, except bone fragments (calcium compounds) and metal (including dental gold and silver and other non-human materials) as the temperature is not sufficient to consume them.


Due to the nature of the cremation process any personal possessions or valuable materials, such as dental gold or jewelry (as well as any body prostheses or dental bridgework) that are left with the Decedent and not removed from the casket or container prior to cremation may be destroyed or if not destroyed, will be disposed of by the Crematory. The Authorizing Agent understands that arrangements must be made with the Funeral Home to remove any such possessions or valuables prior to the time that the remains of the Decedent are transported to the Crematory.


Following a cooling period, the cremated remains, which will normally weigh several pounds in the case of an average-size adult, are then swept or raked from the cremation chamber. Although the Crematory will take reasonable efforts to remove all of the cremated remains from the cremation chamber, it is impossible to remove all of them, as some dust and other residue from the process will be left behind. In addition while every effort will be made to avoid comingling, inadvertent and incidental comingling of minute particles of cremated remains from the residues of previous cremations is a possibility, and the Authorizing Agent understands and accepts this fact.


After the cremated remains are removed from the cremation chamber, all noncombustible material (insofar as possible) such as dental bridgework and hinges, latches, and nails from the container will be separated and removed from the human bone fragments by visible or magnetic selection. The Crematory is authorized to dispose of these materials with similar materials from other cremations in a nonrecoverable manner, so that only human bone fragments will remain.


When the cremated remains are removed from the cremation chamber, the skeletal remains often will contain recognizable bone fragments. Unless otherwise specified, after the bone fragments have been separated from the other material, they will be mechanically pulverized. The process of crushing or grinding may cause incidental comingling of the remains with the residue from the processing of previously cremated remains. These granulated particles of unidentifiable dimensions, which are virtually unrecognizable as human remains, will then be placed into a designated container.





Following the cremation, the Authorizing Agent directs the Crematory and/or Funeral Home to undertake the actions ser forth on reverse side to arrange the final disposition of the cremated remains of the Decedent. If the cremated remains are shipped at any time, the Authorizing Agent directs that the Crematory or Funeral Home utilize registered U.S. mail with a return receipt or a shipping device that uses an internal system for tracing the location of the cremated remains during shipment and requires a signed receipt of the person taking delivery of the cremated remains.


The Authorizing Agent understands that if no arrangements for the final disposition, release or shipment of the cremated remains are made in the Authorization, the Crematory and/or Funeral Home shall hold the cremated remains for thirty (30) days after cremation. If during that thirty (30) day period the cremated remains are not retrieved by the person designated above to receive them or by the Authorizing Agent, or if arrangements for their final disposition are not made, then the Crematory or Funeral Home may return the cremated remains to the Authorizing Agent at sixty (60) days after the cremation and if the Authorizing Agent has not taken delivery of or caused the delivery of the cremated remains, or in the even the arrangements of the final disposition have not been carried out within the sixty (60) days period because of the inaction of a party other than the Crematory or Funeral Home, then the Crematory or Funeral Home may dispose of the cremated remains in a grave, crypt or niche. The Authorizing Agent shall be liable for the cost of such final disposition in a grave, crypt or niche and shall reimburse the Crematorium or Funeral Home immediately upon receipt of an invoice.




The Authorizing Agent acknowledges that teh FUneral Home and Crematory are relying upon the representations being made by the Authorizing Agent in this auhtorization. The Authorizing Agent certifies that all of the information and statements contained in the Auhtorization are accurate and no omissions of any material fact have been made. The authorizing Agent agrees to indemnify and hold harmless teh Funeral Home and the Crematory, their officers, directors, employees and agents from any and all claims, demands, actions, causes of action or suits of any kind or nature whatsoever, incliding, but not imited to, any legal fees arising out of or resulting in from the Funeral Home's and the Crematory's reliance on or performance consistent with the directions, statements, representations and agreements contained in the Authorization.