Pre-Arrangement Form

The form below outlines the information the funeral home will need to collect for Vital Statistics. It can be completed in advance, as part of pre-arrangements, or at the time of need.

To learn more about at-need arrangements, click here.
To learn more about pre-arrangements, click here.

If a death has occurred, please call us at 604-936-9987, as well as completing the form below.

Vital Statistics Information:

Free Text

Please note the Provinical Health Card number and Social Insurance Number will also need to be collected.

Full Name:

Full Address:

Phone Number:

Email Address:

Date of Birth:

Place of Birth:

Occupation:

Business Type:

Number of Years Worked:

Date of Death (if applicable):

Place of Death (if applicable)

Father's Name:

Father's Place of Birth:

Mother's Name (Maiden):

Mother's Place of Birth:

Martial Status:

Spouse's Full Name:

Disposition:

Type of Service:

Viewing:

Jewelry:

Pacemaker

Nuclear Therapy Recipient:

Urn Selection:

Casket Preference:

'Book of Memories' Complimentary Online Tribute Page:

'Eternity's Touch' Digital Fingerprint

Next of Kin Full Name:

Is this Person the Executor?:

Next of Kin Full Address:

Next of Kin Phone Number:

Next of Kin Email Address:

Miscellaneous Notes and Instructions:

Please select one of the options below:

Please contact me to schedule an appointment

Please place my information on file

Please contact me to schedule an appointment

Please place my information on file

The Book of Memories

Click here to learn more about the complimentary Book of Memories online tribute page.

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Eternity's Touch Fingerprints

Click here to learn more about Eternity's Touch unique fingerprint mementos and keepsakes.

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Cremation Urns

Click here to learn more about the variety of wood, biodegradable and metal urns we offer for every budget.

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Cremation & Burial Caskets

Click here to learn more about the variety of cremation & burial caskets we offer for every budget.

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Pre-Arrangement Form

Vital Statistics Information:

The Book of Memories

Eternity's Touch Fingerprints

Cremation Urns

Cremation & Burial Caskets

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