Authorization to Embalm

Option #1)  If you would like to download a blank PDF to print, fill out, scan and email back to us, click here: Option #2)  If you would like to electronically fill out this form, please use the online form below. Fill out the following fields and then click the SUBMIT button at the bottom to send the form. A copy will be automatically emailed to us as well as to you. If you have any questions please feel free to call us for assistance.

The undersigned represents to Northern Illinois Funeral Service (“Funeral Home”) that the undersigned is the surviving spouse of the next of kin of

or is the legal representative of such person, and, as such, has the paramount right to direct the disposition of the body of the decedent.

The undersigned authorizes and directs the Funeral Home, its employees, independent contractors, and agents (including licensed funeral director/embalmer trainees and/or mortuary students under the direct supervision of a licensed embalmer) to care for, embalm, and prepare the body of the decedent. The undersigned acknowledges that the authorization encompasses permission to embalm at the Funeral Home facility or at another facility equipped for embalming.