Pre-Planning Form

1711 18th Street Lewiston, ID 83501 | Phone: (208) 743-4578 | Contact Us

Your Pre-Planning Form

One of the most caring, loving things you can do for your family is to leave detailed information which permits them to make your funeral service a personal tribute in keeping with the way you wanted.

You may use this online form to record your vital statistic and preferred funeral information by filling in the fields. When you hit the submit button at the end, your information is electronically filed with us. This gives you an opportunity to schedule an arrangement conference with our licensed staff so that we can help you secure a detailed pre-arranged funeral plan to meet your needs.

Your Vital Information

These fields will help you to provide the correct information needed to make funeral pre-arrangements. This information is also necessary to file a death certificate with the state in the future.

Full Name:

Street Address:

City / State / Zip:

Telephone: Please enter your telephone number

Email: Please enter a valid email address

Social Security Number

*for your online security, we can get this from you in person*

Next-of-Kin:

Relationship:

Father's Name:

His Birthplace:

Mother's Name (Maiden):

Her Birthplace:

Male

Female

Gender

Gender:

Your Main Occupation:

In What Industry:

Education Level

Have You Designated Someone as a
Durable Power of Attorney for Healthcare?:

Yes

Your Service Preferences

These fields will help you to provide more specific details about your preferences regarding a funeral, memorial, or celebration of life.

Religious Preferences:

Your preferences about having a
viewing or visitation:

Your preferences for a service,
gathering, funeral, or celebration
of life:

Where should it be held?

His/Her Name:

*for your online security, we can get this from you in person*

What should take place?
(special requests for religious
rites, etc.):

Music selections and artists:

Who should lead the proceedings?

Other speakers or readers:

Special readings from prose,
poem, or scripture:

Special mementoes you
would like to have displayed:

Flower preferences:

Preferences for memorial
contributions (charity donations):

Your Preferences for Final Disposition

These fields will help you to provide more specific details about your preferences for final disposition (eg. burial, cremation, donation, etc.)

Chosen method of final disposition
(burial, cremation, other):

If burial, where?

Type of casket:

Type of Vault:

If cremation, what should be done
with the cremated remains?

Preferred Funeral Home:

Do you have a prearranged funeral plan
with a funeral home already?

Yes

If yes, please provide information
(eg. funeral home name, policy
number, etc.):

Determining Your Benefits

These fields will help you to determine if you have any
other burial benefits.

Are you an honorably discharged veteran
of the United States armed forces?

Yes

If yes, do you have a copy of your
discharge papers (DD214)?

Yes

* If you answered yes to both questions, you may be entitled to a variety of military burial benefits (ceremonial flag, military honors, etc.)
CLICK HERE to visit our Military Benefits page

Do you have a valid/current life
insurance policy?

Yes

* If yes, you may be able to designate those funds to pay for your funeral/burial expenses. Not only that, but you may be able to use your policy to "lock-in" the funeral prices and guarantee your funeral plan.
CLICK HERE to visit our Why Pre-Plan page for more information

Information on death benefits from
the Social Security Administration:

* The Social Security Administration will provide a one-time death benefit of $255 - to a surviving spouse only.

Upload Your Own Files

Using these fields, you can upload your own files to send to our office along with your funeral pre-planning details (eg. scanned copy of military discharge papers, a photo to use for an obituary, a Word document of a special poem, etc.)

Choose a file to upload from your computer (optional):

Clicking the "SUBMIT" button below will send all of your information to our office. We can then contact you to make an appointment for an arrangement conference if you like.

Clicking the "PRINT" button below will allow you to print out all of the information you enetered so that you can keep it for your personal records.

Clicking the "RESET" button below will clear all of the fields in the form and delete the data you entered.

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