Request for Autopsy Summary (Lucas county cases only)

2. Request for family members only.
   You may request a summary of the autopsy findings by filling in this form. When the summary is finalized/signed out, we will mail it to you. We will only mail the results to you, we will not email or send the results in any other form. This form is for family members only, business or professional organizations must use the official methods. Requests made by businesses or professional entities will be declined. Requests are accepted for Lucas county deaths only. Deaths occurring in other counties are handled by their respective Coroner.
4. Name of Deceased*
5. Date of Death*
   Date of Death
7. Name of requesting closest legal next of kin*
9. Relationship to deceased*
   How are you related to the deceased?
11. Email Address*
    Enter the email address of the person requesting the information.
13. Address1*
    Address to mail the Autopsy Summary to.
15. Address2
17. City*
    City to mail the Autopsy Summary to.
18. State*
    State to mail the Autopsy Summary to.
19. Zip*
Leave This Blank:


21. 1. Receive an email copy of this form.
22. Email address

    This field is not part of the form submission.

23. Submit

* indicates a required field