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Arrangement Form

Arrangement Now

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.

If death has occurred, please call us at 604-746-3040, as well as completing the form below.

Vital Statistics Information:

Free Text

Please note the required Personal Health Number and Social Insurance Number can be provided over the phone, if preferred.

Full Name:

Full Address:

Phone Number:

Email Address:

Date of Birth:

Place of Birth:

Personal Health Number (PHN):

Social Insurance Number (SIN):

Aboriginal Status:

Occupation (prior to retirement):

Business Type:

Number of Years Worked:

Date of Death (if applicable):

Place / Facility of Death (if applicable)

Father's Full Name:

Father's Place of Birth:

Mother's Full 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 send me information about pre-arrangements

Please send me information about pre-arrangements

Please contact me to schedule an appointment

Please place my information on file

Please contact me to schedule an appointment

Please send me information about pre-arrangements

Please contact me to schedule an appointment

Please send me information about pre-arrangements

Please contact me to schedule an appointment

Please place my information on file

Thank you for your submission.
We will get back to you as soon as possible

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2061 Riverside Road

ABBOTSFORD, BC V2S 6A5

Fax: 604-746-3050

Email: contact@frccs.com

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