Mortuary Verification

Please review the following. By signing below, you confirm your understanding and agreement.

1. I confirm that the above-listed mortuary is a legal and professional provider.
2. The Luna Babies Foundation provides burial/cremation assistance for infants 20 weeks gestation to 1 year of age.
3. I understand that financial assistance must be requested by bereaved families through the “Financial Assistance Request” on the Luna Babies Foundation website — not through the mortuary.
4. I understand that approved financial assistance will be paid directly to the mortuary from the Luna Babies Foundation.
5. The Luna Babies Foundation is a nonprofit organization and assistance is based on funding availability. I will not discuss assistance allotment with families prior to financial assistance being awarded to each individual family.
6. The Luna Babies Foundation cannot reimburse the family or mortuary for services already paid for prior to assistance approval, or services provided more than 30 days prior.
7. I understand that the Luna Babies Foundation requires an itemized receipt from the mortuary prior to the mortuary receiving payment from the foundation.

Beyond assisting families, we’d love to explore additional ways to work together. Select any you’d be interested in discussing:

To complete your verification, please share your pricing. It helps us understand the services available to the families we serve — and it stays private to our team.

By typing your name above, you are signing this verification electronically and confirm you are authorized to do so on behalf of the mortuary.