Personal Information
Family, Work, & Education
Family Information
Additional Family Members
Education History
*Copy of DD214 needed on file at funeral home
Your Wishes
Your Preferences
Work History
Service Requests & Wishes
Visitation/service with casket, then burial
Immediate burial
Visitation/service with rental casket, then cremation
Cremation, then time of gathering/memorial service
Direct cremation (no service)
Disposition Information
*It is imperative to have a long-term plan for any cremated remains in your care.
Where will they go when you pass away?
Biographical Information
Surviving:
Other survivors (special relatives, close friends, pets)
Preceded in death by
Church affiliation & groups within
Lodges/organizations/memberships/hobbies
Important Documents
If you’d like to assign your life insurance policy(s) to the funeral home to be
used for your service costs, please contact your insurance provider and ask for
assignment paperwork, we can then assist in completing them.
*By doing this, you have also protected your assets should you need to qualify for
Medicaid. If you have additional assets, they may be able to be set aside for certain
service items for your immediate family. Let us know if this may be utilized for you.
Insurance information
Veteran information
*It is imperative to know that an urn OR plaque is to be selected IN LIEU OF a
marker. The urn OR plaque are for cremated remains that are NOT going to be
interred in a cemetery.
*Find additional burial/cremation benefits for veterans here:
https://www.cem.va.gov/burial-memorial-benefits/index.asp
Thank you! Your submission has been received!
CONTACT US
Sign up for one year of weekly grief messages designed to provide strength and comfort during this challenging time.
