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BLACK TULIP FUNERALS PTY LTD
Trading as Black Tulip Funerals
7 Burrows Road, St Peters NSW 2044
I, have been advised by the Embalmer of Black Tulip Funerals that viewing of the LATE is strongly advised against.
Qualified Embalmer Full Name:
IPAMS Certification Number:
It is understood by me that the deceased has been prepared by the Black Tulip Funerals Embalmer after an Autopsy / Other: (Specify) to the very best of his / her ability.
I still wish to view the deceased and indemnify Black Tulip Funerals Pty Ltd and the Embalmer for any emotional or mental related stress that may possibly occur to myself as the direct result of my viewing of the deceased named above.
Name:
Relationship to Deceased: (Circle) SNOKNOKOther:
Signature: Date: / /
Name (printed):
Signature: Date: / /
We are committed to provide professional care & service
Black Tulip Funerals Pty Ltd | 7 Burrows Road, St Peters NSW 2044