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Planning Ahead
Services
Obituaries
Family Assistance
Live Stream
Monuments
Cemeteries
About Us
Our Mission
Our Story
FAQs
Contact
Preplanning Form
For more information about
preplanning
, be sure to read our
preplanning
page.
Please enable JavaScript in your browser to complete this form.
Please enable JavaScript in your browser to complete this form.
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Step
1
of 4
Information About Who is Completing This Form
Name
*
First
Last
Phone
*
Address
*
Address Line 1
City
State / Province / Region
Postal Code
Email
*
I Am Planning For
*
--- Select Choice ---
Myself
Spouse
Life Partner
Mother
Father
Child
Sibling
Friend
Other
Next
Information About The Person You Are Planning For
First Name
*
Last Name
*
Middle Name (if applicable)
Gender
*
--- Select Choice ---
Male
Female
Date of Birth
*
Place of Birth
*
Social Insurance Number
Health Card Number
Marital Status
*
--- Select Choice ---
Never Married
Married
Widowed
Divorced
Seperated
Common Law
Marriage Date
Spouse's Full Name
Spouse's Maiden Name
Father's Full Name
Father's Place of Birth
Mother's Full Name
Mother's Place of Birth
Next
Work History
Usual Occupation (most of life)
Type of Business
Place Phone Address
Funeral Service Information
Service Preference
No Service
Graveside Service
Traditional Service
Cremation Service
Memorial Service
Cremation Only, No Service
Place of Service
Place of Viewing / Prayers
Disposition Options
Casket Burial
Cremation
Cemetery
Next
Person To Finalize Arrangements At Time Of Death
Is this information the same as the person's filling out this form?
Yes, it is the same
No, it is not the same
Other Information and Special Instructions
Please list any other instructions or information you wish us to have.
Checkboxes
Contact me to set an appointment to discuss options with Dalmeny Funeral Home staff
Checkboxes (copy)
Contact me to set an appointment to prepay funeral expenses
Checkboxes (copy) (copy)
Please keep my information on file
Submit