First Call Information

1st thing on a notification of death form?

Name of Deceased.

2nd thing on a notification of death form?

location of the deceased

3rd thing on a notification of death form?

Name and relationship of caller

4th thing on a notification of death form?

phone number of caller

5th thing on a notification of death form?

Name of next of kin, if not caller

6th thing on a notification of death form?

Phone number of next of kin

7th thing on a notification of death form? (INCLUDE 7A)

Name of attending physician

• Has the physician or medical examiner been notified?

8th thing on a notification of death form?

Age of the deceased

9th thing on a notification of death form?

Permission to embalm obtained?

In the case the decedent is at a hospital, nursing home, or hospice: 10th thing on a notification of death form? (INCLUDE 10A)

Has a release form been signed?

• By whom?

In the case the decedent is at a hospital, nursing home, or hospice: 11th thing on a notification of death form?

Is there going to be an autopsy performed?

In the case the decedent is at a hospital, nursing home, or hospice: 12th thing on a notification of death form? (INCLUDE 12A)

organ or tissue donation

• Have you been in contact with the donation agency?