Santa Cruz — Autopsy Report Request- English

Source: https://shf.santacruzcountyca.gov/Portals/1/County/sheriff/formsdocs/Autopsy%20Report%20Request%20Fillable%20PDF%202025.pdf

County of Santa Cruz

Sheriff-Coroner

5200 Soquel Avenue, Santa Cruz, CA 95062 (831) 454-7600 Fax (831) 454-7604

Chris Clark Sheriff- Coroner AUTOPSY AND TOXICOLOGY REPORT REQUEST

DECEDENT INFORMATION

DECEDENT NAME: ___________________________________________________________________

DECEDENT DATE OF BIRTH: ______________________ CASE NUMBER: ______________________

REQUESTOR INFORMATION

NAME: _____________________________________________________________________________

EMAIL: _____________________________________________________________________________

MAILING ADDRESS: __________________________________________________________________

CITY: ________STATE: _____ ZIP CODE: PHONE NUMBER:

RELATIONSHIP TO THE DECEDENT: ____________________________________________________

AUTOPSY AND TOXICOLOGY REPORT FEE: $35.00 *** Make checks payable to Santa Cruz County Sheriff *** Note: we do NOT accept out of state personal checks or cash payment via mail, for an online payment option contact Records by phone (831)454-7600 or email SHFRecords@santacruzcounty.us

___ Payment has been made ___ Payment will be made once reports are complete

Payment Method: ___ Cash ____ Check ___ Money Order/Cashier’s Check ___ Credit Card

CASE NOTIFICATION: Please select how you would like to be notified once reports are ready: ___ Call ___ Mail

Reports will be sent out once they are ready for release. If payment has been received beforehand, the reports will be mailed out. If no payment was received Requestor will be notified via phone call or email. SIGN

Date: ________Requestor Signature: ______________________________________________

Please email completed forms to SHFRecords@santacruzcounty.us or mail to:

SCSO Records 5200 Soquel Ave Santa Cruz, CA 95062

FOR OFFICE USE ONLY

APPROVAL SIGNATURE: _______________________________ ID NUMBER: _______ DATE: ______ PAYMENT RECEIVED: Cash __ Check __ Money Order/Cashier’s Check __ Credit Card__ Check/Receipt #: _______