Pre-Planning

The "Pre-Planning Form" helps you share important details for end-of-life arrangements. It covers your personal information, family contacts, and choices for services and burial, making the planning process easier. We will contact you to schedule a preplan appointment upon receipt.

Funeral Recipient's Personal Information

Full Legal Name *

Legal Address *

Social Security Number

Gender

Marital Status

Date of Birth

Country, State, Town of Birth

Father's Name
‍

Mothers Name (including Maiden Name)

Spouse’s Full Legal Name (if applicable)

Spouse's Maiden Name (if applicable)

Education Background of Intended Funeral Recipient

NOTE: Highest level completion.

Veteran Status of Intended Funeral Recipient

NOTE: If Yes, please provide a DD-214 Discharge Certificate. To request a DD-214 from the Veterans Administration click here (10-12 weeks processing): VA Records Request.

Are you Hispanic or Latino?Regardless of your answer to the prior question, please indicate how you identify yourself. (Select one or more)

Employment of Intended Funeral Recipient

NOTE: Even if retired.

Primary Occupation

Name of Last Employer

Cemetery, Mausoleum, or Cremation

NOTE: Please provide your original deed or certificate of ownership.

If burial or using a mausoleum (entombment), in which cemetery do you own space or a crypt?

Religious Services

Will the funeral include religious services at a place of worship or funeral home? If yes, please share the name of the religious institution or clergy.

Visitation Plans

Do you intend to have traditional “visiting hours” at the funeral home, where family and friends can gather?

Funeral Agent

NOTE: Is there a legally appointed Funeral Agent? If yes, provide name and phone number of the funeral agent here.

Name

Phone Number

Children of Intended Funeral Recipient

NOTE: We will require the names and contact information of all biological children of this person.

Number of Children

Nearest Next-of-Kin

NOTE: The first name listed here should be the nearest next-of-kin, such as a spouse, even if the spouse is already listed above.