Advocacy Services Form

The following is only appropriate for the Legal Next of Kin of the Child who died (ie., parent or legal guardian)

I am the legal next of kin for the child who died, and whose name is listed below, and I give my permission for the SUDC Foundation staff to contact the medical examiner and/or coroner office on my behalf to obtain information related but not limited to: status of investigation, how notification of final cause of death will be made to the family, how to request documents, discuss autopsy findings and reports, what specimens are stored, release procedures and retention policy. I understand that the SUDC Foundation will pursue this information in order to pursue advocacy services for my family. I understand this is necessary because medical examiner and coroner offices vary in their policies and procedures. If I further agree to pursue DNA banking services assistance with the Foundation, I authorize and agree to hold harmless the SUDC Foundation, its successors, servants, agents and employees for any damages sustained as a result of their assistance in managing the transfer and shipment of biospecimens from our child's death investigation with the Medical Examiner’s Office to Prevention Genetics Laboratory. The SUDC Foundation cannot be held liable for any damages sustained as a result of this service.