Get the free Autopsy Request Checklist

This document is a comprehensive checklist to be filled out prior to sending a decedent for autopsy at the Children\'s Hospital of Philadelphia. It includes sections for demographic information, autopsy type, clinical summary, and necessary authorization for release of remains. The form outlines the information required for both stillborn and liveborn autopsy requests, as well as guidelines for transportation and documentation.

How to fill out autopsy request checklist

How to fill out autopsy request checklist

1. Step 1: Begin by obtaining the autopsy request checklist form from the appropriate medical authority or institution.
2. Step 2: Fill in the patient's information, including full name, date of birth, and medical record number.
3. Step 3: Specify the date and time of death.
4. Step 4: Provide the cause of death as known, or mark 'unknown' if applicable.
5. Step 5: Indicate the requested type of autopsy (e.g., full autopsy, limited autopsy).
6. Step 6: Include the name of the requesting physician or authorized person.
7. Step 7: Detail any specific questions or areas of concern regarding the autopsy.
8. Step 8: Sign and date the form to authorize the autopsy request.
9. Step 9: Submit the completed checklist to the appropriate department for processing.

Who needs autopsy request checklist?

1. The autopsy request checklist is needed by physicians, medical examiners, hospitals, and families seeking clarification on the cause of death.

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What is autopsy request checklist?

An autopsy request checklist is a standardized document used to gather essential information and ensure that all necessary steps are taken when requesting an autopsy.

Who is required to file autopsy request checklist?

Typically, a licensed physician, a legal guardian, or the immediate family member of the deceased is required to file the autopsy request checklist.

How to fill out autopsy request checklist?

To fill out the autopsy request checklist, you must provide personal details of the deceased, the reasons for the autopsy, relevant medical history, and sign the document to confirm the request.

What is the purpose of autopsy request checklist?

The purpose of the autopsy request checklist is to ensure that all necessary information is collected to facilitate the autopsy process and to clarify the reasons for the examination.

What information must be reported on autopsy request checklist?

The information that must be reported includes the deceased's full name, date of birth, date of death, circumstances surrounding the death, and consent information from the requester.