Reviewed by Carlos Vargas, Texas Licensed Funeral Director (TFSC #119648) ·
The first hours decide a great deal
When a patient dies in a Texas hospital or under hospice care and the family intends to take them home to another country, the people at the bedside are hospice nurses, chaplains, social workers and case managers. None of them arranges the repatriation, but what they hand the family in the first hours often determines whether the next steps move or stall. This page is written for those professionals and for the relatives they are helping.
It describes what Texas requires at the point of release and which pieces of information the funeral director will need first. It makes no statement about any destination country and promises no timing.
Release to the funeral home, and what happens next
The Texas DSHS Death Registration Handbook, revised January 2026, says the funeral director who assumes custody files a report of death with the local registrar within 24 hours, and that a copy of that report serves as authority to transport the body within Texas. For a repatriation the funeral director must also obtain a Burial-Transit Permit, which the registrar issues once a death certificate completed in so far as possible has been presented. The family therefore needs to choose a funeral home before anything else can begin.
When the death falls under a medical examiner, release works differently. The Dallas County Southwestern Institute of Forensic Sciences FAQ says the person is released to the funeral home the family chooses once identification and examination are complete, and that the legal next of kin, in the order of spouse, adult children, parents and siblings, must sign a funeral release form. Staff can help by telling the family which office has jurisdiction and who the next of kin is under that order.
The medical certification is the step staff can speed up
The same handbook explains that the funeral director obtains the cause-of-death information from the attending physician, physician assistant, advanced practice registered nurse, medical examiner or justice of the peace, as appropriate to the circumstances, and that the certifier must complete the medical certification not later than five days after receiving the death certificate or tell the funeral director the reason for the delay. Nothing in a repatriation, including the consulate’s review, can be finished without that certification.
The most useful thing a hospice or hospital can give the family is the name and direct contact of the professional who will certify, so that the funeral director can reach the right person at once. If the family’s faith calls for prompt burial abroad, mention that Texas has a 48-hour provision for religious purposes in counties that have adopted it; our timeline guide describes the written request it requires.
What to hand the family before they leave
A short list prevents most of the calls back to the unit.
| Item | Why it matters |
|---|---|
| Name and direct contact of the certifying professional | The funeral director needs the medical certification before other steps can finish |
| Whether a medical examiner or justice of the peace has jurisdiction | It changes who releases the person and who certifies |
| Who the legal next of kin is, in the statutory order | That person signs releases and later consents |
| Where the patient’s belongings are and who may collect them | Belongings often travel separately from the person |
| The family’s language and one family contact | So the funeral home and the consulate speak with one person |
Families can track belongings with the personal effects checklist. For an infant or child, the infant and child pathway lists the questions that differ.
Questions from hospice and hospital staff
- Can the hospital or hospice start the repatriation paperwork?
- No. In Texas the funeral director files the report of death, the death certificate and the permit to leave the state. The facility’s part is the release and the medical information.
- What slows families down most at this stage?
- Not knowing who will complete the medical certification. Giving the family that professional’s name and direct contact helps more than anything else.
- Does the family need to pick a funeral home before release?
- Yes. The person is released to a funeral home, and in a medical examiner case the legal next of kin signs a release naming it.
