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Get OR OHA 9088 2016-2024
St name: First: MI: Address: City: State: Phone: Email: ZIP: Relationship to decedent: Grandson Great-nephew Granddaughter Great-niece Great-grandson Other: Great-granddaughter Section 3: Method for cremains to be provided Please select the method you want the cremains provided: I will pick-up at the Oregon State Hospital, Salem campus: Staff will call to schedule a pick-up date and time. By proxy: I give permission for the following person to pick up the cremains on my behalf:.
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- Cremains
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