Prearrangement Form

Our prearrangement form is for those who wish to pre-fund their service through the use of a Purple Shield Policy. This is the information we need in order to fill out all of the necessary documentation. If you would prefer to call or meet with us to communicate this information you may do so as well.

If you only have some of the information please fill out as much as you can. The remaining information can be later submitted here or communicated to us over the phone.

If you would like to pre plan for our services but pay for them at the time of need please fill out our Information Form instead.

    Purchasers's Information









    Next of Kin / Executor Information

    Is there a will?

    Beneficiary's Information







    Date of Birth:

    Marital Status







    Services

    Payment

    Service Type

    Would you like more information, or to have us organize, one of the following services?

    I do not wish to organize a service.



    1 Hour Family Gathering

    A family gathering of up to 25 attendees and held at any of our pre-designated locations with an urn present. Flowers, catering, and other services can be arranged.


    Memorial Service

    A 2 hour visitation incorporating a brief formal or ritual service if desired with an urn present. Our staff can arrange for everything, including flowers and catering if desired.


    Visitation and Reception

    A 2 hour visitation followed by a service and ceremony. Families also have the option of a graveside service after the ceremony as well as a reception if necessary.


    Identification

    Being able to see a loved one before a final disposition is helpful for a sense of closure. This is not necessarily a funeral service, but an opportunity to briefly say goodbye for before final disposition.


    Witnessing of Cremation

    Witnessing of a cremation is a service where families wish to witness the actual cremation process. This is a very common request since this type of brief ceremony provides families and friends with a feeling of closure.

    Would you like help settling your estate?

    Are there any additional services you are considering?




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