Address: 602 Birch Street, Scranton, PA, 18505, US
Telephone: (570) 343-0413

602 Birch Street Scranton, PA 18505
(570) 343-0413
CremationsbyCorey.com

REQUEST FOR SERVICE RELEASE
Your Name*
Your Relationship to the Deceased*
Full Name of Deceased*
hereby release his/her remains to Cremations by Corey, LLC for transportation and *limited preparation for final disposition.
*Limited Preparation: is disinfection of the remains, checking the remains for implanted devices(i.e. pacemakers), placing remains in an alternative container, and any other necessary preparations for the cremation process.
Time*

: HH

MM
Date*
Date Format: DD slash MM slash YYYY
Cremations by Corey Staff*
Your Signature*