Consent Forms

  • Next of Kin

  • Deceased Information

  • Date Format: MM slash DD slash YYYY
  • Date Format: MM slash DD slash YYYY
  • :
  • Physician's Name

  • Authorized party

  • Date Format: MM slash DD slash YYYY
  • Any signature (including any electronic symbol or process attached to, or associated with, a contract or other record and adopted by a Person with the intent to sign, authenticate or accept such contract or record) hereto or to any other certificate, agreement or document related to this transaction, and any contract formation or record-keeping through electronic means shall have the same legal validity and enforceability as a manually executed signature or use of a paper-based recordkeeping system to the fullest extent permitted by applicable law, including the Federal Electronic Signatures in Global and National Commerce Act, the New York State Electronic Signatures and Records Act, or any similar state law based on the Uniform Electronic Transactions Act, and the parties hereby waive any objection to the contrary.
  • Date Format: MM slash DD slash YYYY
  • Drop files here or
  • Drop files here or

Please fill out this form and we will send you a email, which will contain document that will require your signature.

  • Date Format: MM slash DD slash YYYY
    pass away on the following date:

Please print documents and use section below to upload.


Irrevocable Assignment and Power of Attorney

Please print documents and use section below to upload.


Application for Burial Purposes

Application for Burial Benefits

Please print documents and use section below to upload.


SOUTHWEST VIDEO WAIVER FORM

Submit Documentation

  • Date Format: MM slash DD slash YYYY