GOVERNMENT OF THE DISTRICT OF COLUMBIA
OFFICE OF THE CHIEF MEDICAL EXAMINER
401 E Street S.W.,
Washington, DC 20024
AUTHORIZATION TO RELEASE A BODY
The District of Columbia Office of the Chief Medical Examiner (OCME) will not release a decedent without receipt of the
SIGNED AUTHORIZATION TO RELEASE A BODY form from the funeral home representative at the time of removal.
Deceased Full Name:
Deceased Race: Gender: Age:
Date of Birth:
Date of Death:
The undersigned herby requests that the DC OCME release the body of the above named decedent to:
Funeral Home or Crematory:
The undersigned represents that he/she is the next of kin of the deceased, as defined in D.C. Official Code § 3-413, or other
person authorized to receive the remains and has full authority to give permission for the release of the body, pursuant to the
following order of priority:
1. Written directive;
2.
Surviving competent spouse, or domestic partner, as defined under § 32-701(3);
3. Sole surviving competent adult child or the majority of the competent surviving adult children;
4. Surviving competent parent or parent(s);
5. Surviving competent adult in the next degree of kindred;
6. Competent adult friend or volunteer.
Next of Kin Signature:*_____________________________________ Date:
*__________________________________
Next of Kin Name*
(Printed): ______________________________________
Relationship to the
Deceased:*_______________________________
Witness Signature:* ______________________________________ Date:*___________________________________
Complete the form and fax it to the OCME ID Unit at 202-698-9100 prior to scheduling a removal. Present the complete and
signed form at the time of removal. If you have questions regarding the form or the decedent release process, call the OCME ID
Unit at 202-698-9000.
OFFICIAL USE ONLY
Mortuary staff _____________ verified decedent's name, race, gender, age and OCME # with transport agent _____________.
OCME Staff Initials Agent Initials
Contact Number:
rev 4/16 - smf
Approved ________________________________
Not Approved ________________________________
Case Number - Completed by
OCME Staff Only
