Form 6 "Order for Disposal of Tissue Kept for Testing" - Queensland, Australia

This version of the form is not currently in use and is provided for reference only.
Download this version of Form 6 for the current year.

ADVERTISEMENT
ADVERTISEMENT

Download Form 6 "Order for Disposal of Tissue Kept for Testing" - Queensland, Australia

Download PDF

Fill PDF online

Rate (4.8 / 5) 35 votes
Page background image
For Coroner’s Office Use:
Form 6
Version 2
QUEENSLAND
CORONERS ACT 2003
(Section 24)
ORDER FOR DISPOSAL OF TISSUE KEPT FOR TESTING
To:
(insert name of entity holding the tissue (eg, a particular pathology laboratory)
I,
(insert name of coroner or other person with power to make the order)
State Coroner
Deputy State Coroner
(tick appropriate box)
Coroner
Order:
1. That, except for the reference blood for toxicology, the tissue which has been kept for testing as part of the following
autopsy(ies)/as per attached list(s)
is to be disposed of upon receipt of this order.
(delete whichever does not apply)
2. That the reference blood for toxicology which has been kept for testing as part of the following autopsy(ies)/as per
attached list(s)
is to be disposed of at the end of two years from the date of testing.
(delete whichever does not apply)
Name of deceased:
Date of death of deceased:
Name and title of coroner
who ordered autopsy:
Date of autopsy:
Tissue:
(insert either “all tissue” or identify particular tissue if some still to be kept)
Date of order:
Place where order made:
Print name of person making order:
Signature of person making the order:
Note:
1.
This form can be used for one or multiple cases.
2.
Tissue includes organs, blood etc.
3.
Section 24(9) of the Coroners Act 2003 provides that if a coroner orders disposal, the entity which is keeping
the tissue must:
a.
if a family member of the deceased person has told the coroner that he or she wishes to test or use the
tissue for a lawful purpose or to bury the tissue—release the tissue to the family member, or the family
member’s representative, for the test, use or burial (burial includes cremation); or
b.
otherwise—arrange for the tissue to be buried (burial includes cremation).
FORM 6 Version 2 – 2 November 2009
For Coroner’s Office Use:
Form 6
Version 2
QUEENSLAND
CORONERS ACT 2003
(Section 24)
ORDER FOR DISPOSAL OF TISSUE KEPT FOR TESTING
To:
(insert name of entity holding the tissue (eg, a particular pathology laboratory)
I,
(insert name of coroner or other person with power to make the order)
State Coroner
Deputy State Coroner
(tick appropriate box)
Coroner
Order:
1. That, except for the reference blood for toxicology, the tissue which has been kept for testing as part of the following
autopsy(ies)/as per attached list(s)
is to be disposed of upon receipt of this order.
(delete whichever does not apply)
2. That the reference blood for toxicology which has been kept for testing as part of the following autopsy(ies)/as per
attached list(s)
is to be disposed of at the end of two years from the date of testing.
(delete whichever does not apply)
Name of deceased:
Date of death of deceased:
Name and title of coroner
who ordered autopsy:
Date of autopsy:
Tissue:
(insert either “all tissue” or identify particular tissue if some still to be kept)
Date of order:
Place where order made:
Print name of person making order:
Signature of person making the order:
Note:
1.
This form can be used for one or multiple cases.
2.
Tissue includes organs, blood etc.
3.
Section 24(9) of the Coroners Act 2003 provides that if a coroner orders disposal, the entity which is keeping
the tissue must:
a.
if a family member of the deceased person has told the coroner that he or she wishes to test or use the
tissue for a lawful purpose or to bury the tissue—release the tissue to the family member, or the family
member’s representative, for the test, use or burial (burial includes cremation); or
b.
otherwise—arrange for the tissue to be buried (burial includes cremation).
FORM 6 Version 2 – 2 November 2009