Online Pre-Planning Form

Make these important decisions in the privacy of your own home with our simple online pre-planning form.

Your Contact Information
I am planning for*
Your Name*
First Middle Last
Address*
Street Address City State Zip Code
Phone Number
Email*
Gender
- Male
- Female

Personal Information (person the preplanning is for)
Name*
First Middle Last
Address*
Street Address City State ZIP Code
City of Birth*
Date of Birth*
Gender
- Male
- Female
Race
- Caucasian
- Black
- Chinese
- Japanese
- Hispanic
- American Indian
- Other
Other (Race)
Citizenship
Approximate Height*
Approximate Weight*
Marital Status
Spouse's Name (Maiden)
Father's Name
Mother's Name (Maiden)

Education
Elementary School - Enter number of years completed
High School - Enter number of years completed or GED
College - Enter number of years completed
Degree / Major
Work History
Occupation (prior to retirement)
Job Description
Military Service
Have you ever served in the Military?
- Yes
- No
Branch of Service
Date Enlisted
Date Discharged

Final Disposition We have no interest in trying to sell you services or merchandise you do not need or want, however, it is important for our staff to be aware of your plans in order to best meet your expectations. Please help us better meet your needs by answering the following:
Private or Public Viewing
Prior to cremation, is there to be any viewing by family or friends? If so, private or public?
Memorial Service
Is there going to be any kind of memorial service or celebration of life? If so, what type of service and where?
Receiving the Cremains
Who is to receive the cremains following the cremation? If more than one person, please list the names of the appropriate parties.
Interrment
Are the cremations to be interred in a cemetery lot or niche? If so, please indicate location.
Veterans
If you are a veteran, do you wish to have a military service at the cemetery?
Scattering Cremains
Are the cremations to be scattered? If so, where and by whom.
Number of Certified Death Certificates Requested
CAPTCHA
Phone
This field is for validation purposes and should be left unchanged.

COVID-19 Update: Losing a loved one is never easy and during this time of uncertainty, we at Heritage Cremation Society remain devoted to keeping things Simple, Sensible and Affordable. Taking care of families is at the center of everything we do. If during this time of uncertainty, you experience the unfortunate loss of a loved one, and you are not comfortable meeting in person; we offer the option of completing all the necessary arrangements electronically, including all required signatures and authorizations. We can also schedule an appointment to meet in the comfort and privacy of your home. Click here to learn more.

Online Pre-Planning Form

Your Contact Information

Personal Information (person the preplanning is for)

Education

Work History

Military Service

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