If you use assistive technology (such as a screen reader) and need a
version of this document in a more accessible format, please email firstname.lastname@example.org.
Please tell us what format you need. It will help us if you say what assistive technology you use.
This form must be completed by medical referees.
The form confirms that:
the cremation meets the regulations
the inquiry or examination made by the persons who gave the relevant certificates was adequate
the fact and cause of death have been agreed, or a coroner has opened an inquest