Next of Kin/Legal Representative

This is to certify that I, the above listed legal next of kin, having the relationship listed above, hereby authorize the stated funeral home to remove and care for the body of the above listed decedent from the Hennepin County Medical Examiner's Office for the purpose of funeral arrangements, embalming, shipping, cremation, burial or other means of final disposition.

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Decedent information

This email address is required so the funeral home receives a copy of this form.

(FD initial and license # here)

  • All fields are required.  
  • Do not change any of the field names within this panel.
  • If user entered values are used to complete one of these fields - that must be done via code.
  • All code for each field is found in the calculate event.
General settings

A dropdown is used - just in case you change these values when in different environments.

This is used to fill in the body of the email.  Something like "NOK Authorization for Removal" or "Tab Renewal"

Note: Make sure to add  '.pdf' to your filename

Email settings - submitter

This value will normally be the email address of whomever is submitting the form.  You can set this value to a value entered by the user.

This value may be the same as the 'email subject - LOB'.  Just code - or copy/paste the value as needed'

Email settings - LOB

This value will normally be the email address of an LOB general mailbox.  Something like: ME.Operations@hennepin.us  

Only one email per field.

(cc)

This value will normally be the email address of an LOB general mailbox.  Something like: ME.Operations@hennepin.us  

Only one email per field. 

If this value should be left blank - noreplay@hennepin.us should be used as the default.  

This value may be the same as the 'email subject - submitter'.  Just code - or copy/paste the value as needed'

  • Double check all of your settings to make sure the emails will look correct when sent.
  • Make sure to hide this panel before sending for review.