Immediate Need

We would like to say, we are sorry for your loss.

If you are looking to speak to one of our licensed funeral directors immediately, please call us at 519-749-8467.

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Immediate Need Form

Contact Name (Your Name):

Contact E-mail:

Contact Phone:

Contact Secondary Phone:

Have you been in contact with us before?

YES

NO

If YES, who have you been in contact with?

Who has passed away?

Where did they pass away?

What is your relationship:

Date of Death:

Social Insurance Number:

Date of Birth:

Birth Place:

Usual Residence:

Type of work done most of working life:

Type of business or industry worked in:

Spouse Name:

Spouse Address:

Father's Name:

Father's Birth Place:

Mother's Maiden Name:

Mother's Birth Place:

Are there pre-arrangments?

Yes

No

If YES, which funeral home are the pre-arrangements with?

Have we previously served your family?

Yes

No

If YES, who was your loved one?

Would you like to share any funeral details with us?

Helpful Items For Funeral Arrangments:

Picture

Clothing

Social Insurance Number Card

Will (if applicable)

IF there is a Will and Testament - Executor Is:

Executor Name (if different than contact):

Executor Relationship

Executor Address (if different than contact):

Executor Phone Number (if different than contact):

Executor Email (if different than contact):

Message:

Immediate Need

Immediate Need Form

Immediate Need Form

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