At Need Form

The Information Form Below Must Be Filled Out

       (At Need Information and Help Form ) 
PLEASE USE THIS FORM BELOW: to provide us with as much detail as you can. Please provide all phone numbers of person to contact before you meet with our staff.

If A Death Has Occurred You Must Call Our 24 Hour Services Line at: 301-253-2138

 *** CREMATION INFORMATION: *** 
 Anyone requesting cremation please note that the Surviving Spouse must sign the Authorization to Cremate Form.

If the spouse is deceased then all surviving Children must sign the Authorization to Cremate Form.

 If it is a child then both parents must sign the Authorization to Cremate Form.

If no family members then the Legal Representative or Representatives must sign the Authorization to Cremate Form. Proof of Representation must be give at time of authorization.

    For more information on who must sign Authorization to Cremate please call our office at :     
 301-253-2138
                                  ****(The Family must obtain a Clergy for any services they request.) *****

( PLEASE SEE REMINDER BELOW )

      NOTE; *** Please do not make or plan any funeral arrangements for any services until you have talked to your funeral director. We will help you plan the Dates and Times for your Services when you meet with us. *********

PLEASE USE FORM BELOW 
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At Need Information Form

Personal Information

**
SS number must be on this form.
Place Your Name and Phone Number Above

Work/Education History

Military Record

Funeral Service Request

Disposition Request

(if applicable)
(if applicable)
(if applicable)

Summary Details

Please use the area above to enter the names of siblings, children

Thank you, Please click the GREEN submit button when done with the Security Question Above ! >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>

DO NOT USE THE FORM BELOW THIS LINE

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STOP! STOP! STOP! 

DO NOT USE FORM BELOW

STOP HERE !!!!!!!!











At Need Details

Personal Information Form

Please use the area above to enter the names of siblings, children and grandchildren.

Work/Education History

Military Record

Funeral Service Request

(if applicable)
(if applicable)
(if applicable)

Summary Details

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