Pre-Arrangement Form

Pre-Arrangement Form
If a death has occurred please contact us directly at 604-936-9913.

We strive to make the pre-arrangement process easy and straightforward for you and your family. Please take a few moments to fill out the online pre-arrangement form provided below. While it may be difficult, we ask that you try to provide us with as much information as possible for the Vital Statistics Agency of BC. Doing so will allow us to begin the pre-arrangement process and completion of necessary documents.

Once these initial questions have been asked, the funeral director will contact you to complete the pre-arrangements by email. Please know that should you have any questions or concerns; please do not hesitate to contact us .

Vital Statistics Information

Full Name (including maiden):

Full Address:

Phone Number:

Email Address:

Date of Birth:

Place of Birth:

Date of Death (if applicable):

Place of Death (if applicable):

Personal Health Number (PHN):

Social Insurance Number (SIN):

Aboriginal Status

Occupation (when actively working):

Business Type:

Number of Years Worked:

Father's Name:

Father's Place of Birth:

Mother's Name (including Maiden):

Mother's Place of Birth:

Martial Status

Spouse's Name (including Maiden):

Type of Service:

Viewing:

Disposition:

Casket Preference:

Cemetery (if applicable):

Urn Preference:

Height (approximate):

Weight (approximate):

Jewelry Removal:

Pacemaker:

Communicable Disease:

Nuclear Therapy Recipient:

Number of Death Certificates ($27):

Were Pre-Arrangements made?

Memorial Society Member:

'Eternity's Touch' Fingerprint Capture:

'Book of Memories' Complimentary Online Tribute Page:

Next of Kin / Contact Person Full Name:

Is this Person the Executor?

Next of Kin / Contact Person Phone Number:

Next of Kin / Contact Person Email Address:

Next of Kin / Contact Person Full Address:

Miscellaneous Notes and Instructions:

Please select one of the options below:

Please send me information about pre-planning

Please contact me to make pre-arrangements

Please place my information on file

Please send me information about pre-planning

Please contact me to make pre-arrangements

Please place my information on file

Please send me information about paying for pre-arrangements

The Book of Memories

Click here to learn more about the complimentary Book of Memories online tribute page.
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Eternity's Touch Fingerprints

Click here to learn more about Eternity's Touch unique fingerprint mementos & keepsakes.
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Cremation Urns

Click here to learn more about the wood, biodegradable and metal urns we offer to suit every budget.
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Cremation & Burial Caskets

Click here to learn more about the variety of cremation & burial caskets we offer.
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