Forms and certificates to download

The 2007 Sands Guidelines contain a number of forms and certificates that health care staff may want to use or adapt.

These forms are available to download as PDFs. They are provided free of copyright for individual Trusts, Health Boards, hospitals and other units to adapt and reproduce as needed.

It is very important that all forms and certificates that may be given to parents are attractively laid out and well reproduced.

For more detailed information about each form and its use, please see Pregnancy Loss and the Death of a Baby: Guidelines for professionals (go to Publications). The relevant chapters are listed below under the description of each form.

Form to give to parents who take the baby's body out of the hospital
There is no legal reason why parents should not take the remains or body of their baby out of the hospital at any gestation. However, for the protection of the parents and to avoid misunderstandings, staff should give them a copy of this form [see Chapter 13: After a loss: Taking the baby's body home.]
To download a PDF of this form please click here
Certificate to be offered to parents of a baby born dead before 24 weeks' gestation
This form should be printed in a different typeface and on special paper to make it more attractive and special for parents. Some mothers will not want to include the father's name on the certificate. In this case Form 2b should be used [see Chapter 16: Certificates and registration: Certification for a baby born dead before 24 weeks' gestation.]
To downlaod a PDF of this form please click here

Certificate to be offered to the mother of a baby born dead before 24 weeks gestation
This is the same form as 2a above but without the space for the father's name.
To download a PDF of this form please click here
Medical certificate authorising burial or cremation of fetal remains of less than 24 weeks gestation.
[See Chapter 16: Certificates and registration: Certification for a baby born dead before 24 weeks' gestation, and Chapter 17: Funerals and sensitive disposal: Contract with a crematorium.]
To download a PDF of this form please click here
Form for preliminary application for communal cremation of fetal remains of less than 24 weeks' gestation.
[See Chapter 17: Funerals and sensitive disposal: Contract with a crematorium.]
To download a PDF of this form please click here
List of fetal remains for communal cremation
[See Chapter 17: Funerals and sensitive disposal: Contract with a crematorium.]
To download a PDF of this form please click here

Forms 3, 4, 5 and 6 have been adapted with the kind permission of Eltham Crematorium Joint Committee.
Application form for the individual cremation of fetal remains made by staff.
[See Chapter 16: Certificates and registration: Certification for a baby born dead before 24 weeks' gestation, and Chapter 17: Funerals and sensitive disposal: Contract with a crematorium.]
To download a PDF of this form please click here

Application form for the individual cremation of fetal remains made by parents
[See Chapter 16: Certificates and registration: Certification for a baby born dead before 24 weeks' gestation, and Chapter 17: Funerals and sensitive disposal: Contract with a crematorium.]
To download a PDF of this form please click here
Creating Memories - Offering Choices
It is vital that parents are offered genuine choices. This form provides a record for staff and should be kept prominently in the notes. It helps to ensure that:
- parents are given time to reflect and decide what they want;
- parents who have declined previous offers are not asked repeatedly if they have changed their minds.
It is very important to use the form sensitively and flexibly and to take into account:
- any views the parents may have expressed earlier;
- the condition of the baby.
If the baby is macerated or visibly abnormal, it may be inappropriate to offer the parents the opportunity to see him or her. However, this is a very fine judgement and should be made by an experienced midwife or nurse, preferably one who knows the mother and can assess how she is likely to react.

If the parents make it very clear that they definitely do not want to see the baby, the offer should not be repeated, but they should be told that they can change their minds. [See Chapter 12: Creating Memories.]
To download a PDF of this form, please click here