Skip to content

West County: (636) 227-4488 | St. Charles: (636) 484-8844 | Florissant: (314) 924-4488 | Downtown: (314) 241-8844

Arnold (636) 227-4491 | West County: (636) 227-4488 | St. Charles: (636) 484-8844 | Florissant: (314) 924-4488 | Downtown: (314) 241-8844 If local numbers are not working:1 (888) 324-2161

More Packages
Pre-Plan
Obituaries
Urns
Testimonials
Contact Us

Home
Cremation Authorization
Obituaries
Urns
Pre-Plan
Prayer Cards
Why Us
Getting Started
Obituaries
Pet Cremation
Blog
More Packages
Contact
Call Us: 314-241-8844
Request For Transport
Flowers

Home / Medical School Donation / National Body Donor Program

Awaiting product image

National Body Donor Program

Name*
First Last
Home Address
Street Address Address Line 2 City State ZIP Code
County
Is this address in the city?
- Yes
- No
Phone*
Birth and Death
Date of Birth
MM slash DD slash YYYY
City Of Birth
State of Birth
Place of Death, or expected place of death
- Home
- Medical Examiner
- Hospital/Nursing Home (Specify Below)
Hospital/Nursing Home
Personal Information
Race
Are you hispanic
- Yes
- No
If yes
(Cuban, Mexican, Puerto Rican, etc.)
Mother's Name (Maiden Name)
First Last
Father's Name
First Last
Marital Status
- Married
- Never Married
- Divorced
- Widowed
- Legally Separated
If Married or separated, Spouse's
First Last
Education Level
Usual Occupation
Type Of Company
Person in charge of your arrangements - Next of Kin
Name
First Last
Address
Street Address Address Line 2 City State ZIP Code
Phone*
Email
Witness*
Comments
I hereby certify that I am the nearest degree of relationship to the deceased and that I have the legal right or am charged to authorize this cremation and the disposal of the cremated remains. I understand that due to the nature of the cremation process, any personal possessions or valuable materials, such as dental gold or jewelry (as well as any body prosthesis or dental bridgework), that are left with the decedent and are not removed prior to cremation will be destroyed or if not destroyed, will be disposed of by St. Louis Cremation Service. I further agree that I will indemnify and hold harmless the Cremator and Funeral Director, their officers and employees from any liability, costs, expenses or claims resulting from this authorization.
Authorization*
- Yes, I authorize the cremation
- Yes, I authorize the cremation for myself
I give St. Louis Cremation authorization for cremation and I understand that this is my digital signature.
Once you have completed the Arrangement form, please press the submit button and your information will be sent to our trusted staff. Thank you for choosing St. Louis Cremation. To verify we have received your form, please call 314-241-8844.
Comments
This field is for validation purposes and should be left unchanged.

Δ

National Body Donor Program quantity

Category: Medical School Donation

Related products

Washington University
Select options
St. Louis University
Select options

Home
Cremation Authorization
Obituaries
Urns
Pre-Plan
Prayer Cards
Why Us
Getting Started
Obituaries
Pet Cremation
Blog
More Packages
Contact
Call Us: 314-241-8844
Request For Transport
Flowers

Downtown

St. Louis Cremation
2135 Chouteau Ave
St. Louis, MO 63103

West County

St. Louis Cremation
14374 Manchester Rd
Ballwin, MO 63011

St. Charles County

St. Louis Cremation
320 Jungermann Rd
St Peters, MO 63376

Florissant

St. Louis Cremation
5 Saint Anthony Ln
Florissant, MO 63031

Arnold

St. Louis Cremation
1544 Jeffco Blvd
Arnold, MO 63010

×