Paragraph 1: medical facility
The name and location of the medical facility, with the date and time.
SF523
Medical Record - Authorization for Autopsy
- Agency
- GSA
- Revision
- Rev. 12/1993
- Fillable fields
- 27
- Pages
- 1
- Official source
- GSA form page
- Checked
- October 20, 2026
Standard Form 523 (SF 523): Authorization for Autopsy
Standard Form 523 (SF 523), Authorization for Autopsy, is a one-page medical record printed as STANDARD FORM 523 (REV. 12-93). Its footer says Prescribed by GSA/ICMR, FIRMR (41 CFR) 201-9.202-1, the same authority GSA's page lists, and GSA hosts a copy in its forms library.
In paragraph 2 the signer requests and authorizes the physicians in attendance at the named medical facility to perform a complete autopsy on the remains of the deceased, subject to any restrictions written on the form, and may list special examinations. In paragraph 3 the signer states their relationship or authority and that they are entitled by law to control the disposition of the remains. Medical facility staff members sign as witnesses, and an administrative block records Medical Examiner/Coroner jurisdiction.
The form says that when authorization is obtained by letter, telegram, voice recorded or monitored telephone call, medical facility authorities complete paragraphs 1, 2, and 3. You can fill it out free in your browser on this page and download the result without an account.
What's on SF 523
Paragraph 2: the authorization
A request for a complete autopsy on the named remains. The form says it may include examination of the head, eyes, spinal cord, chest, abdomen and extremities unless excluded under the restrictions.
Restrictions and special examinations
A space for restrictions, marked If No Restrictions, Write "None", and a space for any special examinations requested.
Paragraph 3 and witnesses
The signer's relationship or authority, two signature lines, and two witness lines for medical facility staff members.
For administrative use only
Whether the case falls within the jurisdiction of the Medical Examiner/Coroner, and whether the Medical Examiner/Coroner released the remains, each yes or no, with signature, title and date.
Patient's identification
Name (last, first, middle), grade, date, and hospital or medical facility, with register and ward numbers.
The page is laid out in numbered paragraphs followed by signature and identification blocks.
How to fill out SF 523
- 1
Identify the facility
Enter the name and location of the medical facility and the date and time in paragraph 1.
- 2
Name the deceased
Write the name on the line after on the remains of in paragraph 2.
- 3
State any restrictions
List any restrictions on the autopsy. The form says If No Restrictions, Write "None". Then list any special examinations requested.
- 4
Sign paragraph 3
Enter the relationship or authority to the deceased and sign on the Signed lines.
- 5
Witnesses sign
Medical facility staff members sign the witness lines with their name and title.
- 6
Administrative block
Answer the two Medical Examiner/Coroner questions and add the signature, title and date, then complete the patient's identification.
These steps follow the order of the paragraphs on the page.
Why fill Form SF523 on indox
You get the real form, filled in a browser tab, with nothing standing between you and the finished PDF.
- Fill the form right in your browser, no software to install
- Free to fill and free to download, with no account
- The official blank straight from the GSA, not a copy someone retyped
- Works on a phone, tablet or computer
Where it goes and what the form says
Where it goes
The PDF prints no filing address. It is labeled Medical Record, and the form refers to attaching records to it for permanent file.
Authorization not given in person
By letter, telegram, voice recorded or monitored telephone call: medical facility authorities complete paragraphs 1, 2, and 3 and attach the letter, telegram, voice recording or memorandum confirming the call.
Tissues and organs
Paragraph 2 authorizes removal and retention or use of parts, tissues or organs for diagnostic, scientific or therapeutic purposes, and final disposal as prescribed by competent authority in the facility.
Prescribing note
The footer says Prescribed by GSA/ICMR, FIRMR (41 CFR) 201-9.202-1.
Copies
The top of the form says AUTHORIZED FOR LOCAL REPRODUCTION.
Related forms
Who signs SF 523?
The form names each signer and when medical facility authorities complete it.
Official sources and the blank
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Questions about Form SF523
Who issues SF 523?
The footer says Prescribed by GSA/ICMR, FIRMR (41 CFR) 201-9.202-1, and GSA's page lists the same authority. GSA hosts a copy in its forms library, printed as STANDARD FORM 523 (REV. 12-93).
Who signs SF 523?
The person who states in paragraph 3 that they are entitled by law to control the disposition of the remains, plus two witnesses who are medical facility staff members.
What does a complete autopsy include, according to the form?
Paragraph 2 says it may include, but not be limited to, examination of the head, eyes, spinal cord, chest, abdomen and extremities unless excluded under the restrictions.
Can the autopsy be limited?
The form says the authority is granted subject to the restrictions written in the space provided, and If No Restrictions, Write "None".
What if authorization is given by phone or letter?
The form says medical facility authorities complete paragraphs 1, 2, and 3, and the letter, telegram, voice recording or memorandum confirming the call is attached to the form for permanent file.
What is the administrative block for?
It records whether the case falls within the jurisdiction of the Medical Examiner/Coroner and whether the Medical Examiner/Coroner released the remains to this authority, with a signature, title and date.