Additional Required Forms:
  • This form must be completed by Coroner or Medical Examiner representative
  • Deceased Identification form must be completed by Coroner/Medical Examiner or referring county representative

Referring Investigator

Coroner's or Medical Examiner's information

Deceased information

Next of Kin

Last seen

Please enter 4 digits military time eg. 1201 will be 12:01.

Who was the decedent last seen by?

Where was the decedent last seen alive?

Found / Pronounced By

Location where the decedent was found/pronounced

Injury location

Please enter 4 digits military time eg. 1201 will be 12:01.

Circumstances

Body transported by

Expected arrival:

Please enter 4 digits military time eg. 1201 will be 12:01.

Donation timing and authorization must be approved by Hennepin County Autopsy Physician.

Next Of Kin was advised of the intent to perform an autopsy and did not object.

As the referring Coroner Medical Examiner, I hereby authorize the Next of Kin and/or Party Authorizing Release to arrange for removal of the body from the Hennepin County Medical Examiner’s Office for the purpose of funeral arrangements, shipping, cremation, burial or other means of final disposition.

Next of kin or person authorizing release

Information comes from Autopsy referral Next of Kin.

Information comes from Autopsy referral Next of Kin.

Decedent name

Note: Information comes from Autopsy referral Deceased information.

Note: Information comes from Autopsy referral Deceased information.

Note: Information comes from Autopsy referral Deceased information.

Coroner/Medical Examiner

NOTE: Information comes from Autopsy referral Coroner's or Medical Examiner's information section.

NOTE: Information comes from Autopsy referral Coroner's or Medical Examiner's information section.

As the referring Coroner Medical Examiner, I hereby designate, on my behalf the following agency and designee to remove the decedents body from the Hennepin County Medical Examiner’s Office for the purpose of livery only.

Transport agency/Designee

Decedent name

Note: Information comes from Autopsy referral Deceased information.

Note: Information comes from Autopsy referral Deceased information.

Note: Information comes from Autopsy referral Deceased information.

Coroner/Medical Examiner

NOTE: Information comes from Autopsy referral Coroner's or Medical Examiner's information section.

NOTE: Information comes from Autopsy referral Coroner's or Medical Examiner's information section.

Please Note:

  • The Authorization For Removal Form is indicating that you/your agency is allowing the body to be released from the Hennepin County Medical Examiner by the person you feel is making final disposition decisions; this may not correlate with legal NOK per state statute. If determining NOK is an issue, it is the obligation of your county/your office to assume responsibility for clarification and indicate that to our office.
  • The Deceased Identification Form will be sufficient for I.D. purposes unless the Hennepin County Medical Examiner feels that a confirmatory identification is warranted.
  • All clothing and property will be returned to the agency removing the body from our office, however items that are felt to correlate with the possible cause of death (e.g. ligature, illicit substances, etc.) will be shipped to your agency at your expense.