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.
Complete this certificate to confirm information given in form Cremation 4, the cremation medical certificate completed by a doctor who treated the person during their last illness.
This Cremation 5 form must only be filled in by medical practitioner who’s been fully registered for 5 years and holds a licence to practise.
The medical practitioner must not:
be a relative of the person who died
have issued the cremation medical certificate
be a relative, partner or colleague in the same practice or medical team as the person who issued the initial certificate