Cremation Amendment Regulations 2012 (WA)

2944 GOVERNMENT GAZETTE. WA 29 J ii nc• 2012

HE3O1*

Cremation Act 1929

Cremation Amendment Regulations 2012

Made by the Governoi , in Executive Council.

1.             Citation

These regulations are the Cremation Amen r.liirent
Regulations 2012.

2.             Commencement

regulation 11 shall he accompanied by the fee

These re^-ulations come into operation as follows

(a)	regulations I and 2 — on the day on which these regulations are published in the Gazette;
(b)	the rest of the regulations on the day after that day.

3.             Regulations amended

These regulations amend the Cremation Regulations 1954.

4.             Regulation 12 replaced

Delete regulation 12 and insert:

12.          Other requirements for permit

Every application to crenate made in accordance with

29 June 2012 GOVERNMENT GAZETTE, WA 2945

prescribed in Appendix B" and a certificate in

accordance with —

(a)	Appendix "A" Form 7. completed by a medical practitioner; or
(b)	Appendix "A" Form 8. completed by the Coroner ; or
(c)	the Coroners Regithitions 1997 Schedule I Form 4, completed by the Coroner.

5.             Appendix "A" amended

In Appendix "A" delete Form 7 and insert:

Form 7

t 'i-emation Act 1929

Certificate of Medical Practitioner I orm7

Certificate to he completed by doctor who attended deceased prier to death.
Add additional pages if more space is rcyuircd.

plash copies Or all rcleva]]t [ah(l]aton reports. results. ccrtilicates etc.

Deceased	Name
Address
Dais 0rhirth Acs
\•larita] status Malc Female
t. )ccu )ation
llactor	Name
Address

Are you a spouse, de facto partner or relative of the deceasecP

No

Yes. Nature of relationship

As tar as \ OLi ale aware. do \ OLI hia•c a pcCLln]ar y ]ntcres[ in the deceased's estate or any other- ppecLIn]ar} interest in the deceased's death"

No

Yes. Give details

Were \OLi the deceased's LisLia] doctor.

No Yes

2946 GOVERNMENT GAZETTE. WA 29 .Jiro ' 2012

Recent care oi'	During the 4 weeks prior to death did the deceased receive
deceased	medical or nursing c^tre?

No

Yes. Where was the deceased cared for?

Hospital

Nursing [ionic

Homo

Other

If cared for at home or other place, who provided care?

Professiona] health care providers
Relatives, friends, others

Give names and relationship to the deceased

1)id \OU attend the deceased during his or her ]ast illness?

No Yes Since what date? /20

Did stn} other doctor(s) at Rnd [he deceased during" his or ccr

]gist illness?

No

Yes. Give names

[,as[ illness	Briel c]inica] hiistor\ of l ast illness includin(y dia,noses and events leading to death.
Details of	I)ate /20 Time a.rn.ip.m.
death
Pace where the deceased died

Home

Address Hospital Address Other

Address

29 June 2012 CTO\TERNITENT CTAZETTE. W.\ 2917

Were you present when the deceased died?

Yes

No. When did you last see the deceased alive?

I)ate /20 I i me a.m./p.m.

Did you examine the deceased's body after death?

No

Yes. Give details

1 O YOU have any reason to suppose that a ILIrther examination

of the deceased's remains may he desirahle?

No

Yes. Give details

['cruse of death Was a post mortem performed?

No

Yes. Give details of results

(* Ifa Medical	I)id }ou sign the Medica] Certificate of Cause of'Ikath?
Certificate of
Cause of'f?eath	Yes
is attached,	No. Name of the doctor ho signed the certificate
answers are
not required to
these
questions.)	I]irect cause of death

*.Antecedent causes of death (if any)

Conditions contrihutinC to or aceeleratine death (if any)

2948 GOVERNMENT GAZETTE. W,\ 29 Jiin( , 2012

Clinical	1]o VOLI kno, or have reason to suspect, that the deceased's
observations	death was directly or indirectly due to any of [he to] owing? (lick or circle if yes)

violence
oisol1
privation or neglect
medica] proCedLIre
drowning
SLIffocation
1) LI i ns

In view of [lie deceased ' s lifestyle and hiea]th. do you have an y doubts about the character of the deceased's i]]ncss or cause of death?

No

Yes. Give details

Sifety of	At [he time of death was the deceased fitted with a cardiac
cremation	pacemaker, defihri]]ator or other battery operated implant or device?

NofNot known

Yes. Has it been removed? Yes No

Had the deceased received any of [lie following radioactive

[reatmen ts?

Palliation , for hone metastases

• Strontium-89 injection durinw the 12 months prior to death

No Yes*

• Samarium-153 injection during the 3 weeks prior to death

No Yes*

Kheni um- 1 RR injection during the week prior to death

•

No Yes*

tnfrrsion for liver cancer or metastases

• Yttrium-90 or Rhen]um-188 during the 2 weeks prior to death

No Yes*

7'hE rapt' for thyroid cancer, endocrine tumours, or non-

Ilodgkin's lymphoma

• Iodine-131 (injection or oral) during the week prior to death

No Yes*

1; adioactive implant (permanL ntj e.g. for prostate cancer

• Iodine-125 seed implant during the 12 months prior to death

No Yes*

29 Jun' 2012 GOVERNMENT CT1ZETTE , WA 2949

if yes — contact the Radiation Safety Off eer. PEi sicist at the

treating institLltion for provision of regLiired
information to the Crematorium.

Are yOLi aware of an}thing else that CoLI]d render cremation un safe?

No

Yes Give details

Certification	I certif! that the information Set out al7Um e is true and
of ineelicaI	correct xncl that I have not oinittecl an y relevant
practitioner	information.
S]^z natLirc

Date :20

6.            Appendix "B" amended

In Appendix `B" delete "94.00" and insert:

97.90

By Command of the Governor,

N. HAGLEY. Clerk of the Executive Council.

HE302'^ Poisons Act 1964

Poisons Amendment Regulations (No. 3) 2012

Made by the Governor in Executive Council.

1.             Citation

These regulations are the Poisons Amendment Regi(lalions

(Na. 3) 2012.