As of January 1, 2011, King County medical examiner charges a $50 disposition fee for their required disposition review request.
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Deceased Vital Information
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| Sex (M/F) |
Male Female * |
| Social Security Number |
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| Birthdate (MM/DD/YYYY) |
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| Birthplace (City, Town or County) |
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| State or Foreign Country |
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| Was the decedent ever in the Armed Forces? | Yes No Unknown |
Deceased Education
(Check the box that best describes the highest degree or level of school completed at the time of death.) |
8th grade or less (Specify)
9th - 12th grade, no diploma
High school graduate or GED completed
Some college credit, but no degree
Associates Degree (e.g. AA, AS)
Bachelor's Degree (e.g. BA, AB, BS)
Master's Degree (e.g. MA, MS, MEng, MEd, MSW, MBA)
Doctorate (e.g. PhD, EdD) or Professional degree (e.g. MD, DDS, DVM, LLB, JD) |
Was Decedent of Hispanic Origin (required by the State of Washington)?
(Check the box that best describes whether the decedent was Spanish/Hispanic/Latino or check the "No" box if decedent was not Spanish/Hispanic/Latino.) |
No, not Spanish/Hispanic/Latino
Yes, Mexican, Mexican American, Chicano
Yes, Puerto Rican
Yes, Cuban
Yes, other Spanish/Hispanic/Latino
(Specify):
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| Decedent's Race (Check one or more races to indicate what the decedent considered himself or herself to be.) |
White
Black or African American
American Indian or Alaskan Native
Asian Indian
Chinese
Filipino
Japanese
Korean
Vietnamese
Samoan
Other
(Specify):
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| Estimated length of time at residence (Specify units (e.g. 6 years, 6 months, etc.)) | |
| Usual Occupation (Indicate type of work done during most of working life. - DO NOT USE RETIRED) |
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| Kind of Business/Industry (Do not use Company Name) |
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| Father's Name (First, Middle, Last, Suffix) |
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| Mother's Name Before First Marriage (First, Middle, Last) |
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| Marital Status at Time of Death | Married
Married, but separated
Widowed
Divorced
Never Married
Unknown |
| Surviving Spouse's Name (Give name prior to first marriage) |
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| Surviving Spouse's DOB (MM/DD/YYYY) |
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| Surviving Spouse's SSN |
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You must notify the place of death that Cascade Memorial is your funeral home of choice, and that you give them permission to release your loved one into our care.
Please call us at 425-641-6100 to report the death, so that we may dispatch our removal team to the place of death.
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