Phone: 1-405-354-2533

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Home
Obituaries
Forms
- Immediate Need
- Advanced Planning Form
About Us
Our Ministries
Services
Plan Services Ahead
- Planning Ahead
- Instructions to My Loved Ones
Veterans
Grief & Guidance

Immediate Need

In this section

Immediate Need

Advanced Planning Form

We want to offer you our warmest sympathy for the passing of your loved one. Please complete this online form to provide our staff with information to begin the arrangement process. Information must be provided in full within 72 hours of the passing before additional charges begin to incur. Once the completed form is submitted, our Funeral Director will walk you through the next steps. Please call our office at (405) 354-2533 with any questions.

Immediate Need Information

Personal Information of Your Loved One

Full Legal Name (First, Middle, Last)

Maiden Name

Street

City

State/Province

ZIP/Postcode

Date of Birth

Place of Birth (City, State)

SSN #

Race (select all that apply)

WhiteBlack or African AmericanAmerican Indian or Alaska Native specify tribe belowAsian IndianChineseFilipinoJapaneseKoreanVietnameseOther Asian specify belowNative HawaiianGuamanian or ChamorroSamoanOther Pacific Islander specify belowOther Race specify belowUnknown

Father's Full Name (First, Middle, Last)

Mother's Full Name (First, Middle, Last)

Mother's Maiden Name

Race Other - specify

Ethnicity - Hispanic Origin?

Ethnicity - Hispanic Origin Other

Marital Status

Spouse's Name

Spouse's Maiden Name

Additional Family Members: ChildrenPlease use the area above to enter the names of children, if any. (Identify those who are deceased)

Additional Family Members: GrandchildrenPlease use the area above to enter the names of grandchildren, if any. (Identify those who are deceased)

Additional Family Members: SiblingsPlease use the area above to enter the names of siblings, if any. (Identify those who are deceased)

Additional Family MembersPlease use the area above to enter the names or total number of any other type of family members. (Identify those who are deceased)

Work/Education History

Education Level

Grade-School (8th grade or less)High-School with diploma or GEDHigh-School with no diplomaSome college credit with no degreeAssociate DegreeBachelor's DegreeMaster's DegreeDoctorate or Professional DegreeUnknownNot Classifiable

Occupation (Do not list Retired or Disabled)

Company Name

Type of Business or Industry

Military Record

Did they serve in the military?

YesNo

Is there a copy of the discharge papers (DD-214)?

YesNo

Funeral Or Cremation Preferences

Funeral Preference

Free Cremation through Donation

Cremation Only

Cremation with Seeing Your Loved One

Cremation with Memorial Service

Burial

Place of Service

Place of Service Other - Please Specify

Place of Visitation

Final Disposition Preference

Cemetery

Next of Kin Information

Person (Legal Next of Kin) in charge of final arrangements

Relationship Type

Legal Authorized Agent

Spouse

Adult Child

Parent

Adult Sibling

Appointed Guardian

Other (Please specify)

**Next of Kin listed by Legality

Relationship Type - Specify DetailsList further information if necessary

Street

City

State/Province

ZIP/Postcode

Telephone

Email Address

Next of Kin IDPlease Attach a Picture ID of Next of Kin

ID Verification of DeceasedPlease Attach a Picture of Loved One for ID Verification

Additional Details

Additional instructions or requests for us

By signing my name, I understand that if this information is not submitted within 72 hours of my loved one's time of death, additional charges may begin to incur.

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Immediate Need

We are here to assist you. If a death has occurred or you need immediate assistance, you can reach us at:

1-405-354-2533

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