Get Funeral Director Reimbursement Form - Sharenj

Navigating the Funeral Director Reimbursement Form - Sharenj is essential for funeral homes seeking reimbursement for their services related to organ and tissue donation. This guide provides clear, step-by-step instructions to assist users in completing the form effectively and accurately.

Follow the steps to complete the Funeral Director Reimbursement Form - Sharenj online.

1. Press the ‘Get Form’ button to access the form and open it in your preferred editor.
2. Enter the decedent’s full name, ensuring to complete the first, middle, and last name fields clearly.
3. Input the date of death using the format MM/DD/YYYY.
4. Indicate whether an autopsy was performed by selecting 'Yes' or 'No'.
5. Select only one reimbursement procedure from the options provided, including solid organ donation, skin donation only, long bone donation only, or a combination of the mentioned.
6. Record the date of embalming using the format MM/DD/YYYY.
7. Answer the questions regarding the family's inclusion of donation language and ‘Donate Life’ insignia in the obituary by selecting 'Yes' or 'No'. If 'Yes', note you will receive an additional $15.00.
8. Calculate the total reimbursement requested by selecting the appropriate amount: $250, $375, $450, or $650.
9. Fill in the funeral home’s name and complete the address details, including city, state, and ZIP code.
10. Document the funeral director in charge of arrangements and provide the necessary signature.
11. Add the license number of the funeral director and date of submission.
12. Ensure to include a copy of the executed statement of funeral goods and services selected (SFGSS) with your form.
13. Once all information is complete, save your changes, download, print, or share the form as required.

Take action now and complete your documents online for timely submission.