HOME
ABOUT US
OBITUARIES
SERVICES
PLANNING AHEAD
GRIEF SUPPORT
RESOURCES

HOME
ABOUT US
OBITUARIES
SERVICES
PLANNING AHEAD
GRIEF SUPPORT
RESOURCES

HOME
ABOUT US
OBITUARIES
SERVICES
PLANNING AHEAD
GRIEF SUPPORT
RESOURCES

FOR IMMEDIATE ASSISTANCE

Plan Ahead

Online Preplanning Form

Online Preplanning Form

Full Name

Relationship to beneficiary of prearrangement

Address

Email Address

Phone Number

First Name

Middle Name

Last Name

Full Street Address

Date of Birth

City and State of Birth

Father's Name

Mother's Name (Include Maiden)

Marital Status

Spouse's Name (With Maiden)

Date of Marriage

City and State of Marriage

Free Text

LIST SURVIVORS NAMES AND RELATIONSHIP

Survivors

Free Text

EDUCATION/WORK HISTORY

Highest Level of Education

Occupation

Work History

Free Text

MEMBERSHIPS/HOBBIES

Lodge/Union/Assoc. Membership

Did this person serve in the military?

Yes

No

If yes, branch of service

Free Text

Your Wishes

Visitation Options

Visitation at funeral home

Visitation elsewhere

No Visitation

Funeral Service Option

Funeral service at funeral home

Funeral service elsewhere

No Funeral Service

Reception Options

Reception at funeral home

Reception elsewhere

No Reception

Would you prefer burial or cremation?

Burial

Cremation

Final Disposition

Ground Interment (burial)

Mausoleum Entombment (above ground burial)

Columbarium (for cremation urns)

Ashes returned to family

Would you prefer to include a graveside/committal service?

Yes

No

Free Text

Your Preferences

Please list any musical selections you would like to include in your services.

Please list any special themes you would like to include in your services.

Please list any poems, religious texts, or readings you would like to be read at your services.

Please list any interests or hobbies you would like to include with your information.

Free Text

Summary Details

Additional instructions for us

Memorial requests or donations to charity

Free Text

Anti-Spam Security Question

Please Answer the following math Question.

Thank you! Your submission has been received!

Oops! Something went wrong while submitting the form.

CONTACT US

Schroder mortuary silvis

Schroder mortuary COLONA

Harris - Nadeau Mortuary Template - Official

GriefSteps

A Year of Grief Support

Sign up for one year of weekly grief messages designed to provide strength and comfort during this challenging time.

© Schroder Mortuary. All Rights Reserved.

Privacy Policy | Terms of Use | Admin Login

Share by: