Download DNA Authorization - Donahue Funeral Home

The OPTION to save DNA
 You should know that, family (or familial) DNA
has medical and genealogical value.

Brochure and 1.5 min. At-Need video support material available.
 After cremation or burial DNA is lost.
 We can save the genetic record (DNA) if you
would like to as this is the last opportunity to do
so.
Alternatively, if you can’t decide immediately...
1. We can Save a Sample (swab/hair) for several
days during your time with us.
2. Please visit the DNA Memorial website.
3. Notify us if you wish to consider DNA banking.
 Would you like an email reminder?
Donahue Funeral Home
1218 Bethlehem Pike Ste. 20
Flourtown, PA 19031
DNA Banking Authorization for Funeral Planning
DNA Sampling: The cremation process destroys all DNA and burial makes it very difficult to retrieve. It is not
possible to collect DNA from cremated remains. To make DNA retrieval and/or storage most plausible, it is
necessary to take DNA samples from the Decedent’s remains prior to cremation or burial.
As Authorizing Agent, I authorize the collection of a cheek swab and a hair sample from the
Decedent’s remains for the purpose of DNA retrieval and/or storage in accordance with the contract
for services that I will enter into with the DNA storage company.
As Authorizing Agent, I decline any DNA retrieval and/or storage and direct that no cheek swab or
hair sample be collected from the remains of the Decedent for those purposes.
Signed this
day of
, 201__.
Name of person being sampled:__________________________________________________________
Authorizing Agent Name
Funeral Home Representative
Authorizing Agent Signature
Funeral Home Representative Signature
Terms and Conditions of DNA Sampling
1.0 The funeral director and CG Labs guarantee that no testing or storage will be undertaken by any
organization and all the DNA will be returned to the person being sampled.
2.0 Due to the advanced processes of CG Labs, DNA extraction from cheek swabs should yield high quantity
DNA yields and allow multiple genetic testing per vial (50+ tests) including WGS (whole genome
sequencing). However, due to inherent sample quality and quantity variation within DNA samples, not all
samples can be used for every test and CG Labs or the funeral director cannot be held responsible for
sample quality or quantity. Sample yields will be displayed on certificate issued to families upon return of
DNA sample.