COMMUNITY PROTECTION SERVICE

BEREAVEMENT SERVICES

Cemeteries and Crematorium Office, Teesside Crematorium,

Acklam Road, Middlesbrough, TS5 7HDTel. 01642 817725Fax 01642 852424

TEESSIDE CREMATORIUM – NOTICE OF CREMATION

This notice is confirmation of the telephone booking arrangements and must be sent with all appropriate statutory forms to the above address to arrive no later than 11 am on the last working day before the cremation (i.e. excluding Saturdays, Sundays and public holidays)

Any changes to these instructions will not be implemented until they are confirmed in writing.

Office hours Mon – Thursday 8-30 am to 5 pm Friday 8-30 am to 4-30 pm

1 / DAY, DATE, TIME & CHAPEL / DAY …………….. DATE ……………. TIME………..
ST. BEDE’S / ST. HILDA’S CHAPEL (delete as appropriate)
2 /

FULL NAME OF DECEASED

3 / AGE AND SEX / ……………….. YEARS MALE / FEMALE (delete as appropriate)
4 / COMMITTAL / A)departure through aperture
B)draw curtains
C)coffin to remain in view (delete as appropriate)
5 / OFFICIANT’S NAME AND DENOMINATION / …………………………………. …………………………………
C of E / Free church / RC / other …………….
(delete as appropriate)
6 / SERVICE / Full / committal (delete as appropriate)
7 / MUSIC TRIBUTES
For computer music please state title, artist and when to be played.
I confirm that I have checked the current list at and that I have arranged with Wesley Media for all items not on the list / Organist / computer music (delete as appropriate)
8 / OTHER WESLEY MUSIC SERVICES
(delete, and complete forms W1, W2 and W3 as indicated and refer to the “Procedures for Wesley Media Visual and Recorded Services at Teesside Crematorium” for further information) / 1. Include a Visual Tribute (+ W1, W3)
2. Audio CD Recording of the service (+W1,W2,W3)
3. DVD Recording of the service (+W1,W2,W3)
4. Private Internet broadcast of the service(+W1,W2,W3)
9 / DISPOSAL OF CREMATED REMAINS /
SEE OVERLEAF
10 / FUNERAL DIRECTOR
Name, address and telephone no.
Please indicate any ‘non-standard’ material used for coffin (wool, wicker, bamboo etc) and size of any outsized heavy coffins (i.e. over 28” wide)
……………………………………………………………………………………………..…………
I confirm that the coffin, fittings and contents conform to the requirements as stated in the document “Instructions to funeral directors”
Signed ………………………………………………………………………………………………………..

AUTHORITY FOR THE DISPOSAL OF THE CREMATED REMAINS

OF (name of deceased) …………………………………………………
FOR BABIES UP TO SEVERAL MONTHS OLD PARENTS MUST BE ADVISED THAT THERE MAY BE NO CREMATED REMAINS. / Please state your exact requirements here in full.
1 / RETAINED AT THE CREMATORIUM PENDING DECISION.
If it is too difficult to make a decision at the time the cremated remains can be kept at the crematorium for up to one month without charge. Thereafter a monthly storage fee will be charged. Our representative is available to discuss the options available either at the family’s home or at the Crematorium Office.
2 / SCATTER ON MONTHLY PLOT IN THE GARDEN OF REMEMBRANCE
Cremated remains are normally scattered two days after the cremation service on the plot for the month of cremation or on a plot for a previous cremation. Families can be present when the cremated remains are scattered so an appointment needs to be arranged.
PLEASE STATE IF THE FAMILY WISH TO BE PRESENT WHEN THE CREMATED REMAINS ARE SCATTERED / FAMILY PRESENT
YES / NO
3 / PLACED IN AN ABOVE-GROUND VAULT
Individual granite memorials are available where cremated remains can be sealed behind a memorial tablet with a suitable inscription.
4 / BURIAL IN OR SCATTERING ON A GRAVE
Cremated remains can be buried in or scattered on a grave in any of the Council’s cemeteries subject to the written permission of the registered owner of the grave. There is a charge for burial. A grave may also be purchased for the burial of cremated remains.
There are lawn, traditional, woodland and re-used graves available.
5 / REMOVAL FROM THE CREMATORIUM FOR DISPOSAL ELSEWHERE
Cremated remains can be removed from the crematorium for disposal elsewhere. The funeral director or someone else may collect them from the Crematorium Office. Proof of identity is required with written permission from the applicant for the cremation where necessary.
Cremated remains can be returned to the crematorium at any time.
Disposal on private land would require the permission of the owner.

6 /

CONSENT FOR THE DISPOSAL OF ORTHOPAEDIC IMPLANTS & METAL RESIDUES.

ENVIRONMENTAL POLICY

All metals remaining after the cremation will be disposed of in the most suitable manner to reduce the impact on our environment. This will include the sensitive recycling of metals to avoid the use of non-renewable resources and comply with existing legislation. Should you wish to dispose of the metals in any other way then please indicate by ticking the box below and the metals will be returned to you with the cremated remains. A leaflet explaining the policy is available on request.
TICK ONLY IF YOU REQUIRE ALL METAL RESIDUES TO BE RETURNED TO YOU

7 / Information about memorials etc. will be sent to the person signing Form A within the next two weeks. If this information is not required please indicate opposite.
Please give name & address to which memorial details should be sent if different from Form A /

APPLICANTS SIGNATURE

I have carefully read the above details and I confirm they are correct and I accept the above conditions for the sensitive disposal of metals following cremation.
Signed …………………………………..………………..
PLEASE PUT A CROSS IN THE
BOX IF YOU DO NOT WISH TO
RECEIVE MEMORIAL
INFORMATION
Alternative name and address for memorial details
..…………………………………………………………………...
……………………………………………………………………..