ABOUT US
OUR LOCATIONS
OBITUARIES
RESOURCES
SERVICES
PLAN AHEAD
GRIEF SUPPORT
MEDICARE
- Medicare Reviews

Thoughtful Planning Guide & Appointment

ABOUT US
OUR LOCATIONS
OBITUARIES
RESOURCES
SERVICES
PLAN AHEAD
GRIEF SUPPORT
MEDICARE
- Medicare Reviews

Preserve Cherished Memories

Getting Started

We are here to assist you with your funeral preplanning needs. We'll help you make decisions about your funeral service in advance and reduce unnecessary stress for you and your loved ones.

Arrangement Form

How Can We Help?

A Death Has Occurred

Planning For The Future

Preferred Name for Obituary or Publication

First Name

Middle Name

Last Name

Maiden Name, If Applicable

Birthdate

Date of Death

Person Arrangements Are For's Street Address

Address Line 2

City

State

Zip

Birth City / Township

Birth State

Age

Social Security Number

Education

8th or less

9th - 12th

HS/GED

Some College - No Degree

Associate's Degree

Bachelor's Degree

Master's Degree

Doctorate

Father's First Name (if known)

Father's Middle Name (if known)

Father's Last Name (if known)

Mother's First Name (if known)

Mother's Middle Name (if known)

Mother's Last Name (if known)

Mother's Maiden Name (or list as unknown)

Occupation (or list as unknown)

Industry/Type of Business (or list as unknown)

Military Service

Yes

No

Branch of Service (if applicable)

Marital Status

Married

Widowed

Divorced

Never Married

Child

If Married, Name of Spouse

Spouse Middle Name

Spouse Last Name

Gender

Male

Female

Free Text

Responsible Party

Information in the Responsible Party section is pertaining to the next of kin or the person who will be acting as the responsible party for the family.

Responsible Party's First Name

Responsible Party's Middle Name

Responsible Party's Last Name

Relationship

Responsible Party's Address

Address Line 2

City

State

Zip

Contact Email Address

Contact Phone Number

Select Preferred Funeral Home

Free Text

Living Relatives

Please provide information for the beneficiary's living relatives below.

Is the deceased's father still alive?

Yes

No

Is the deceased's mother still alive?

Yes

No

SURVIVING FAMILY

Name and Relationship of Surviving Family Members

Name and Relationship of Surviving Family Members

First Name

Last Name

Email Address

Relationship

DECEASED FAMILY

Name and Relationship of Deceased Family Members

Name and Relationship of Deceased Family Members

First Name

Last Name

Email Address

Relationship

Free Text

Other Service Details

Please indicate the type of service you are arranging:

Burial

Cremation

Other/I'm Not Sure Yet

Location for Service

Funeral Home Chapel

Graveside

Church

Other / I'm Not Sure Yet

If known, who will officiate the service?

Cemetery Name

Cemetery Location (City)

Cemetery Location (State)

Free Text

Thank You

If you have any questions, concerns or requests for additional service, please outline it below, and you may discuss during our arrangement conference. Then, hit Submit to finalize your form.

Your Message

Thank you for contacting us.
We will get back to you as soon as possible.

Oops, there was an error sending your message.
Please try again later.

Our Locations

Claybar | Orange
Claybar | Bridge City
Hillcrest Memorial Gardens
Haven of Rest Crematory
Orange Forest Lawn Cemetery
Claybar Haven of Rest Cemetery
Blooms by Trendz Floral

Information

About Us
Our Staff
Plan Ahead
Contact

Resources

Obituaries
Send Flowers
Services Overview
Preplanning Form

Privacy Policy | Terms of Use | Admin Login