Funeral Intake Form for Office

Funeral Intake Form for Parish Office

For the Parish Office to complete upon notification of a funeral.

* Indicates required field

Name of Decedent *

First

Last

Date of Death *

Age at Death *

Name of Next Kin *

First

Last

Date of Birth *

Relationship to Deceased *

Email *

Home Address *

Postal Code *

Phone Number *

Date/Time of Funeral *

Body or Cremated Remains? *

Day/Time/Location of Prayer Service *

Reception in Hall? *

Estimated Attendance *

Interment to Follow? *

Interment Immediately after Reception *

Time & Location of Interment after Reception *

Funeral Home *

Organist Required? *

Do you want the funeral in the announcements/bulletin? *

Any other comments? *

Submit