The Representative authorizes and directs S.L. Booker Family Funeral Services, LLC., its employees, independent contractors and agents to care for, embalm, perform restorative measures and prepare the body of the Decedent. 

The Representative acknowledges that this authorization encompasses permission to embalm at the S.L. Booker Family Funeral Services facility or at another licensed facility equipped for embalming, In providing this authorization, Representative acknowledges that embalming is not an exact science and that results may be adversely impacted by a number of factors, including, but not limited to, the conditions under which the death occurred; time lapse between death and the onset of the embalming procedure; physical conditions at the time of death; medications, especially analgesics administered prior to death; life-saving procedures; cause of death; storage procedures of the releasing institution; natural elements; tissue I organ donations; and post mortem (autopsy) examinations.

If no authorization can be obtained, complete the following:

I hereby acknowlege that

has made a reasonable effort over a period of at least

hours to obtain authorization to embalm the deceased. I take full responsibility for performing embalming without permission.

If Authorization to Embalm is DECLINED: 

The undersigned, who represents the deceased, hereby declares that having the legal authority to do so, declines authorization to embalm the above-named deceased individual. Furthermore, the undersigned understands that without embalming/preservation/disinfection of the deceased, S.L. Booker Family Funeral Services cannot guarantee the possibility of viewing the deceased at a later time. The undersigned further states that they will hold harmless S.L. Booker Family Funeral Services, its officers, agents, and employees from any claims of cause of action arising out of their decision not to embalm.