By checking the above box, I hereby request and authorize Simple Alternatives to transfer the deceased into their care. I represent that I am the next of kin of the deceased with authority in matters pertaining to the disposition of the remains of the deceased.
I acknowledge that Pennsylvania law requires human remains held 24 hours beyond death to be embalmed or sealed in a container that will not allow fumes or odors to escape or kept under refrigeration, if this does not conflict with a religious belief or medical examination. I authorize Simple Alternatives to keep the remains of the deceased under refrigeration if a decision has not been made within 24 hours beyond death regarding embalming or the final means of disposition. My religious beliefs permit the use of either embalming or refrigeration.
I acknowledge that it has been explained to me that embalming will be furnished only after my permission is obtained. If verbal permission to embalm is given, written confirmation will be executed at the initial arrangement conference.
I acknowledge that charges apply from the initial transfer of the deceased into Simple Alternatives care, but that I will only be charged for goods and services that I select or authorize. It is my intent to meet with a licensed funeral director at the first mutually convenient opportunity to discuss funeral options and document decisions regarding funeral arrangements.