Request for Cremation Authorization

Per TCA §38-7-108, funeral directors are required to obtain authorization from the county medical examiner prior to cremation. To obtain authorization from the West Tennessee Regional Forensic Center for a Shelby County Death, please complete the authorization request form below and include a copy of the decedent’s certified death certificate. Our investigators will review and process your request as quickly as possible. Most requests will be resolved within 24 hours, however some request may take longer. You will receive updates on the progress of your request via email. Once authorization is granted, a TN DOH Permit for Cremation of Human Remains form with the medical examiner signature will be emailed to you at the email address provided below.  

Please note: We have instituted a $25 fee for request processing. This fee is separate from fees levied at the Shelby County Health Department Vital Records Office.

• Requests must be for Shelby County Deaths only
• Requests must be accompanied by a copy of a certified Shelby County death certificate. A copy of the registered death certificate may be downloaded directly from VRISM. For help obtaining a copy through VRISM, please contact the VRISM helpdesk at 855.874.7686
• Requests may be submitted manually at the West Tennessee Regional Forensic Center at 637 Poplar Avenue between the hours of 8 am and 4:30 pm.

Validate Email

Shelby County *

YesNo

Is this request for a Shelby County death?

Decedent Information

Name

First Name *	Middle Initial	Last Name *

Sex *

• Male
• Female

Place of Death

Facility Name

Address *

City *

State *

- Select State -AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashington, DCWashingtonWest VirginiaWisconsinWyoming

Zip Code *

Location Type *

If you do not see the proper location type listed below, you can add a custom entry.

- Select a Location Type -Hospital InpatientHospital ER/OutpatientNursing Home/Skilled Care FacilityHospice FacilityHospice ResidentialResidence of DecedentResidence Other

Dates

Date of Birth *

Date of Death *

Informant

Name

First Name *	Middle Initial	Last Name *

Contact

Phone Number *

Please use 10 digit phone number format with dot (.) notation.

Relationship *

- Select A Relationship -MotherFatherSisterBrotherSonDaughterAuntUncleNieceNephewGrandmotherGrandfatherGranddaughterGrandsonStepmotherStepfatherStepdaughterStepsonOther

Certifying Physician

Name

First Name *	Middle Initial	Last Name *

Contact

Phone Number *

Please use 10 digit phone number format with dot (.) notation.

Choose a Funeral Home *

Funeral Director Information

Name

First Name *	Middle Initial	Last Name *

Contact

Email *	Verify Email *

Death Certificate Upload *

PDF only

File name:

File size: