Get Hrrf

The Human Remains Release Form (Hrrf) is a critical document that must be completed by hospitals, nursing care institutions, and hospice facilities in accordance with various regulations. This guide offers a clear and comprehensive overview of how to fill out the Hrrf online, ensuring that all necessary information is provided accurately.

Follow the steps to successfully complete the Hrrf online.

1. Press the ‘Get Form’ button to access the Hrrf and open it in your document editor.
2. Begin by entering the facility name and street address, including the city/town and county of the deceased person's care.
3. Provide the deceased person’s full name, ensuring to include their first, middle, and last names.
4. Fill in the date of birth in the format MM/DD/YYYY.
5. Enter the date of death, also in the MM/DD/YYYY format.
6. Indicate the sex of the deceased by selecting either 'Female' or 'Male'.
7. Specify the time of death using the HH:MM format and designate AM, PM, or Military time.
8. If applicable, provide fetal death information including the mother’s name and maiden last name, date of delivery, and estimated gestational age or weight.
9. Complete the section for the person authorizing the facility to release the human remains by providing their full name, relationship to the deceased, and phone number.
10. Input the current health care provider’s full name and contact information, including the phone and fax numbers.
11. Detail the most recent diagnosis as listed in the deceased person's medical record.
12. Indicate any diagnoses or conditions the deceased was suspected of having at the time of death by checking the appropriate boxes.
13. Specify whether notification under ARS 11-593 is requested based on the circumstances of the death.
14. Confirm whether the death was reported and, if so, provide the name of the person you spoke to.
15. If relevant, indicate if the organ procurement organization has been notified regarding the removal of human remains.
16. Have the person representing the facility sign and print their name.
17. Obtain the signature and printed name of the person accepting custody of the human remains.
18. Finally, specify the date and time when custody was transferred.
19. Review all the information for accuracy, then save your changes. You can download, print, or share the completed form as needed.

Start filling out the Hrrf online today to ensure compliance and proper documentation.