Authorization & Collection Form

Please complete the form below to authorize the collection of the deceased patient.

Deceased Patient Information

Fill in the details of the deceased patient.

First Name *

Last Name *

Gender *

Size *

Date of Birth *

Date of Death *

Address

Address Line 1 *

Address Line 2

City *

County

Postcode *

Place Of Death

Use same address as deceased person

Address Line 1 *

Address Line 2

City *

County

Postcode *

Collection Address

Use same address as deceased person

Address Line 1 *

Address Line 2

City *

County

Postcode *

Next of Kin Details

Enter the details of the next of kin.

First Name *

Last Name *

Telephone *

Next of Kin Address

Use same address as deceased person

Address Line 1 *

Address Line 2

City *

County

Postcode *

Funeral Details

Select the type of funeral service and provide relevant details.

Borough *

Funeral Type *

Church of Choice

Pastor of Choice

Pastor Contact Number

Pastor Contact Email

Cemetery of Choice

Date of Choice *

Month *

Week of Month *

The week and month are dependent on availability of third parties (disclaimer of date of choice)

Packages *

Select a package for the funeral service.

Standard PackageTraditional PackageSignature PackagePremium Casket Package

Funeral Director's Authorisation

Review the details below. These will be used for the official authorisation.

Funeral Director's Authorisation

*I/We:
Of (Address):

Hereby do confirm that *I am/We are the next-of-kinfor the Late/Estate of The Late (Name of Deceased):
Of (Last Address):
Who died on:
At (Place of Death):

*I/We also confirm that *I/We have this

Given *My/Our authority to Abney Funeral Services to undertake all arrangements necessary or reasonably incidental thereto and to enter into contract with other persons on *My/Our behalf for the Burial or any other services requested by *Me/Us with regards to the Late.

*I am/We further agree to be jointly and severally responsible for the payment of all expenses incurred by Abney Funeral Services in respect of the burial, or other lawful disposal of the deceased. This payment must be made no later than Seven (7) working days prior to the day of the funeral.

Abney Funeral Services reserve the right to commence or decline any part or all of the services requested by *Me/Us unless this authorisation is duly signed by the person(s) accepting this agreement or intending to enter into legal relations with Abney Funeral Services.

It is agreed and understood that Abney Funeral Services will not be liable for any cost, damages, for negligence, emotional distress or otherwise which are unforeseeable and flow from the failure of any florist, printer or any other external service provider, or any carrier, whether by sea, air, or land, to transport any body within the United Kingdom or from the United Kingdom to any other country according to its schedule, charter or agreed contract dates for shipping and / or carriage of any body. It is further understood that *I/We:

Hereby appoint Abney Funeral Services to be *My/Our agent in all dealings with third parties, in all matters relating to the Burial or other legal means of disposal of the human remains of the Late:

Note: The signature field will appear on the final document download. Please ensure this is signed. No digital signature is required on this website.

Embalming Authorisation

Review the details below. These will be used for the official authorisation.

1. PARTIES

Name of Funeral Home:Abney Funeral Services

Name of Representative:

Name of Deceased:

2. REPRESENTATIVE AND RELATIONSHIP TO THE DECEASED

Relationship to the Deceased:next-of-kin

3. AUTHORITY OF REPRESENTATIVEThe REPRESENTATIVE warrants and represents to the ABNEY FUNERAL SERVICES that the REPRESENTATIVE is the person or the appointed agent of the person who by law has the paramount right to arrange and direct the disposition of the remains of the deceased and that no other person(s) has a superior right over the right of the REPRESENTATIVE.

4. EMBALMING AUTHORISATIONThe REPRESENTATIVE authorises and directs the ABNEY FUNERAL SERVICES, its employees, independent contractors and agents (including apprentices and/or mortuary students under the direct supervision of a licensed embalmer) to care for, embalm, perform restorative measures and prepare the body of the DECEASED. The REPRESENTATIVE acknowledges that this authorisation encompasses permission to embalm at the funeral home facility or at another facility equipped for embalming. In providing this authorisation, the REPRESENTATIVE acknowledges that embalming is not an exact science and that results may be adversely impacted by a number of factors, including, but not limited to, the conditions under which the death occurred; time lapse between death and the onset of the embalming procedure; physical condition at the time of death; medicines, especially analgesic administered prior to death; life saving procedures; cause of death; storage procedures of the releasing institution; natural elements; tissue/organ donations; and post-mortem (autopsy) examinations.

Note: The signature and date fields will appear on the final document download. Please ensure these are signed. No digital signature is required on this website.

I have read and understood the Funeral Director’s Authorisation and Embalming Authorisation. *