The Burial and Cremation (Pregnancy Loss Prescribed Information and Forms) (Scotland) Regulations 2018

Regulation 6

SCHEDULE 1Form 1

$\\scotland.gov.uk\dc1\fs5_home\u102334\Pregnancy loss forms - 7-12-18 - final version (002)_Page_01.tiff$

$\\scotland.gov.uk\dc1\FS5_Home\U102334\Pregnancy loss forms - 7-12-18 - final version (002)_Page_02.tiff$

Regulation 8

$\\scotland.gov.uk\dc1\FS5_Home\U102334\Pregnancy loss forms - 7-12-18 - final version (002)_Page_03.tif$

$\\scotland.gov.uk\dc1\FS5_Home\U102334\Pregnancy loss forms - 7-12-18 - final version (002)_Page_04.tif$

$\\scotland.gov.uk\dc1\FS5_Home\U102334\Pregnancy loss forms - 7-12-18 - final version (002)_Page_06.tif$

$\\scotland.gov.uk\dc1\FS5_Home\U102334\Pregnancy loss forms - 7-12-18 - final version (002)_Page_07.tif$

$\\scotland.gov.uk\dc1\FS5_Home\U102334\Pregnancy loss forms - 7-12-18 - final version (002)_Page_08.tif$

Regulation 9

$\\scotland.gov.uk\dc1\FS5_Home\U102334\Pregnancy loss forms - 7-12-18 - final version (002)_Page_09.tif$

$\\scotland.gov.uk\dc1\FS5_Home\U102334\Pregnancy loss forms - 7-12-18 - final version (002)_Page_10.tif$

$\\scotland.gov.uk\dc1\FS5_Home\U102334\Pregnancy loss forms - 7-12-18 - final version (002)_Page_11.tif$

$\\scotland.gov.uk\dc1\FS5_Home\U102334\Pregnancy loss forms - 7-12-18 - final version (002)_Page_12.tif$

$\\scotland.gov.uk\dc1\FS5_Home\U102334\Pregnancy loss forms - 7-12-18 - final version (002)_Page_13.tif$

Regulation 10

Unique identification number (assigned by the hospital and entered into the cremation register by the crematorium)
The gestational age of the fetus or still-born child

The name of the individual to whom the authorisation to make arrangements for the remains of the fetus or stillborn baby to be buried or cremated is communicated and the date on which the authorisation is given
That the woman has authorised the health authority to make arrangements for the burial or cremation (where applicable)
Where the woman does not provide authorisation—
the name of the individual who made the decision to authorise the health authority to make arrangements for burial or cremation of the fetus and the individual’s relationship to the woman; or
the name of the individual who made the decision to authorise the health authority to make arrangements for the burial or cremation of the still-born child and the individual’s relationship to the still-born child
The way in which the remains of the fetus or still-born child are to be buried or cremated as specified in the decision to authorise the health authority to make arrangements for burial or cremation (where applicable)
Where there is a change in a decision to authorise the health authority or an individual of, or over the age of, 16 to make arrangements for the burial or cremation of the fetus or still-born child, a record of all changes made including a change in the way in which the remains are to be buried or cremated and a change to who is authorised to make the arrangements for burial or cremation

The name of the individual who collected the fetus or still-born child from the mortuary and the date of collection
That the remains of the fetus or still-born child were buried or cremated (whichever is the case)
The place of the burial or cremation (whichever is the case)

Unique identification number (assigned by the hospital and entered into the cremation register by the crematorium)
The gestational age of the fetus or still-born child

The basis on which the health authority is authorised to make arrangements for the burial or cremation of the fetus or still-born child

The name of the individual who collected the fetus or stillborn baby from the mortuary and the date of collection
That the remains of the fetus were buried or cremated (whichever is the case)
The place of the burial or cremation (whichever is the case)