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.

Full Name:

Phone Number:

Email Address:

Free Text

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:

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:

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: