MEDICAL EXAMINER REPORT REQUEST FORM

A COPY OF THE DEATH CERTIFICATE IS REQUIRED FOR DEATHS PRIOR TO 2014

OCME policy requires that all reports are sent to the authorized recipient by standard US Postal Service.

Pursuant to G. L. c. 38, § 2 and 505 CMR 1, the Office of the Chief Medical Examiner ( OCME) may, in its discretion, provide a copy of an autopsy report of a decedent ( if available) to the decedent’s surviving spouse or the next closest living relative if there is no legal spouse at the time of death.

In cases of unnatural or suspicious death where the district attorney or his law enforcement representative is directing and controlling the investigation of the death pursuant to G. L. c. 38, § 4, the district attorney or his law enforcement representative has determined, in his discretion and in writing, that they do not object to the disclosure of the autopsy report to the spouse or next of kin.

To request a copy of an autopsy and/ or toxicology report, the legal next of kin should complete this form either online or submit it to our office via email at

CME Admins

or by standard US Postal Service to the following address:

Office of the Chief Medical Examiner

Attn: OCME Report Request

720 Albany Street

Boston, MA 02118

Date of Death(Required)

Date of Birth(Required)

Name of the Deceased(Required)

First Middle Last Suffix

Name of Requester(Required)

First Last

Relationship to Deceased(Required)

Mailing Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Telephone Number(Required)

Email Address(Required)

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Name(Required)

I ___ State and affirm under the pains and penalties of perjury that the information included herein is true and accurate.

First Last

Signature(Required)

Date(Required)

Name of Organization

Mailing Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country