Form 4 "Order Allowing Person to Observe Autopsy" - Queensland, Australia

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For Coroner’s Office Use:
Form 4
QUEENSLAND
CORONERS ACT 2003
(Section 21)
ORDER ALLOWING PERSON TO OBSERVE AUTOPSY
I,
State Coroner
Deputy State Coroner
Coroner
1.
State that:
I have consulted and considered the views of the following family member of the deceased person:
(give details including identity and relationship to the deceased person of the family member)
I have consulted and considered the views of the doctor who is to conduct the autopsy:
(print name of doctor)
I have also consulted and considered the views of the following persons:
(print name of persons and reasons why they were consulted)
or
it has not been practicable to consider the views of the persons referred to above because:
(print reasons)
2.
Order that I allow:
(print name of person)
being a person whom I consider has a sufficient interest in the autopsy, to attend the autopsy of the body of:
(print name of deceased person)
Date of autopsy:
(print date of autopsy)
Time of autopsy:
(print time of autopsy)
Place of autopsy:
(print place where autopsy is to be conducted)
Date of order:
Place where order made:
Name of person making the order:
(print name of person issuing the order)
Telephone number of person making the order:
(print telephone number)
Signature of person making the order:
Note:
Coroner must give prior notice of the time and place of the autopsy to a person being allowed to observe the autopsy.
FORM 4 Version 1 – 6 November 2003
For Coroner’s Office Use:
Form 4
QUEENSLAND
CORONERS ACT 2003
(Section 21)
ORDER ALLOWING PERSON TO OBSERVE AUTOPSY
I,
State Coroner
Deputy State Coroner
Coroner
1.
State that:
I have consulted and considered the views of the following family member of the deceased person:
(give details including identity and relationship to the deceased person of the family member)
I have consulted and considered the views of the doctor who is to conduct the autopsy:
(print name of doctor)
I have also consulted and considered the views of the following persons:
(print name of persons and reasons why they were consulted)
or
it has not been practicable to consider the views of the persons referred to above because:
(print reasons)
2.
Order that I allow:
(print name of person)
being a person whom I consider has a sufficient interest in the autopsy, to attend the autopsy of the body of:
(print name of deceased person)
Date of autopsy:
(print date of autopsy)
Time of autopsy:
(print time of autopsy)
Place of autopsy:
(print place where autopsy is to be conducted)
Date of order:
Place where order made:
Name of person making the order:
(print name of person issuing the order)
Telephone number of person making the order:
(print telephone number)
Signature of person making the order:
Note:
Coroner must give prior notice of the time and place of the autopsy to a person being allowed to observe the autopsy.
FORM 4 Version 1 – 6 November 2003