Pursuant to Maryland Health Code 5-310 (b)(2), I hereby execute this Certificate of Religious Belief::
Any autopsy of my body is a violation of my religious beliefs. Any procedure which allows the post-mortem deterioration of my body is a violation of my religious beliefs.
Further, it is my wish and directive that my remains be placed into cryopreservation as soon as possible following my death.
Dated: ___________________________________
Signed: __________________________________
Printed Name: _____________________________
Witnessed:
Dated: ____________________________________
Signed: ____________________________________
Printed Name: ______________________________
Address: __________________________________
Witnessed:
Dated: ____________________________________
Signed: ____________________________________
Printed Name: ______________________________
Address: __________________________________
SOURCE: Maryland Certificate of Religious Belief