Funeral Home Invoices

LifeCenter Northwest understands that donation may increase the time, materials and other resources needed to prepare donors to meet the needs of their family. Please fill out this form and submit an invoice for additional services provided to accommodate organ and tissue donation.

Funeral Home*

Main contact*

Address*

Where you would like the payment sent.

Donor Name*

Date received donor*

Choose one of the following:

Embalming

Please note:

This should only account for additional time needed above and beyond standard embalming.

Transportation

Invoice to LifeCenter*

LifeCenter will reimburse the funeral home at a rate of $50 per hour for up to 6 hours. Please upload a statement of services for reimbursement.

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Questions?

Please contact jose.armenteros@lcnw.org or call 425-628-0386

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