The process following the passing of a loved one is not only emotionally taxing but also involves a series of procedural steps, one of which includes an Inventory Personal Effects form, a crucial document in managing the personal belongings of the deceased. This form, used notably by the UIHC Autopsy Service, involves a detailed listing of all clothing and personal effects of the deceased at the time of their passing. It is initiated with the essential details including the patient's name, the date, and the hospital number if applicable. The form is meticulously structured to ensure a comprehensive account of belongings is kept, detailing their description and the intended course of action for each item. The disposition section, a key part of this form, requires input from various parties including nursing staff, family members, or those directly involved in the patient's care, as well as autopsy staff and personnel responsible for transporting the body. Signatures from each party involved affirm the accuracy of the recorded information and the agreeable transfer of items. This document plays a vital role in the transparent and respectful handling of personal effects, often serving multiple purposes, including legal and sentimental. Upon completion, the original document is filed within the UIHC autopsy facility, with copies distributed as necessary to the family, nursing staff, and funeral directors. This ensures all parties have the needed documentation for further proceedings, highlighting the importance of this thorough process in providing peace of mind during such trying times.
| Question | Answer |
|---|---|
| Form Name | Inventory Personal Effects Form |
| Form Length | 2 pages |
| Fillable? | Yes |
| Fillable fields | 125 |
| Avg. time to fill out | 25 min 30 sec |
| Other names | uihc service clothing personal, uihc service personal effects, autopsy personal effects, clothing personal form |
Page ____ of ____
UIHC Autopsy Service
POSTMORTEM INVENTORY OF CLOTHING & PERSONAL EFFECTS
Patient Name: ____________________________________________________________________________
Date initiated: _________________ |
Hospital Number (if applicable): _____________ |
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DESCRIPTION |
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DISPOSITION |
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(Completed by Nursing Staff or Patient Family) |
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(Completed by Autopsy Staff) |
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Clothing and Personal Effects: (Use multiple pages if necessary) |
UIHC |
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Funeral |
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Other |
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Home |
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(specify) |
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Signature of nursing staff or |
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family member releasing body |
Signature: ________________________ |
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(and clothing/effects if |
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Date: _______ |
Time: ______ |
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applicable) to autopsy staff or to |
Print Name: _____________________________ |
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transporting personnel: |
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Signature of transporting |
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personnel transferring body |
Signature: ________________________ |
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(and clothing/effects if |
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Date: _______ |
Time: ______ |
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applicable) to autopsy |
Print Name: _____________________________ |
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personnel: |
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Signature of Autopsy Staff |
Signature: ________________________ |
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receiving body (and |
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Date: _______ |
Time: ______ |
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clothing/effects if applicable): |
Print Name: _____________________________ |
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Signature: ________________________ |
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Signature of person to whom the |
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body (and clothing/effects if |
Print Name: _____________________________ |
Date: _______ |
Time: ______ |
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applicable) is released: |
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Released by: _____________________________ |
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Completed original document to be filed in UIHC autopsy facility; photocopy completed document as needed for family, nursing staff, funeral director, etc.