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AUTOPSY AND DISPOSITION OF MY REMAINS
I, --, hereby nominate -- to be my agent for purposes of directing an autopsy and controlling the disposition of my remains.
I understand that my agent will be able to authorize an autopsy (an examination of my body after my death to determine the cause of my death) and to direct the disposition of my remains unless I limit that authority in this document. I also understand that my agent or any other person who directed the disposition of my remains must follow any instructions I have given in a written contact for funeral services, my will or by some other method.
(Directions: If any of the statements below reflect your desires, sign next to that statement. If none of these statements reflect your desires and you want to limit the authority of your agent to consent to an autopsy and/or to dispose of your remains, you should write your own statement. Under some circumstances, the law may require that autopsy be performed even if you have refused to authorize your agent to consent to one.)
AUTOPSY
( -- ) I hereby consent to an examination of my body after my
death to determine the cause of my death.
( -- ) My agent may not authorize an autopsy.
DISPOSITION OF REMAINS
( -- ) I prefer that my agent direct the disposition of my
remains by the following method (check one):
Burial -- Cremation --
( -- ) My agent may not direct the disposition of my remains
and I would prefer that
--
(name and address)
--
--
direct the disposition of my remains.
( -- ) I have prescribed the way I want my remains disposed of
in (check one):
-- A written contract for funeral services with
--
(name of mortuary/cemetery)
...