At-Need Form

Personal Information

Name (for whom these arrangements are for)(Required)

First Middle Last

Name at Birth (if different)(Required)

Height(Required)

Weight(Required)

Address(Required)

Street Address City Postal Code

Birthplace(Required)

Date of Birth(Required)

Place/Facility of Death(Required)

(If imminent, please put intended place)

Date of Death(Required)

(If imminent, please put date of birth)

Occupation(Required)

(If retired, state last occupations details)

Industry(Required)

Years(Required)

SIN(Required)

Health Card #(Required)

Marital Status(Required)

Name of Husband or Wife(Required)

(incl. Maiden name)

Full Name of Father(Required)

First Middle Last

Father’s Place of Birth(Required)

Full Name of Mother(Required)

First Middle Last (Maiden)

Mother’s Place of Birth(Required)

Physician’s Name(Required)

Do they have a Pacemaker/Other Radioactive Device?(Required)

Communicable Disease?(Required)

How many Death Certificates will you require?(Required)

Radiation/Chemotherapy in the last 2 years? Where on body/What Type/When?(Required)

Are there any belongings that need to be returned to family?(Required)

Clothing – if needed (including undergarments, socks, shoes, etc.)(Required)

Executor/Next-of-Kin Information

Name(Required)

First Middle Last

Relationship(Required)

Phone(Required)

Address(Required)

Street Address City Postal Code

Email(Required)

*We will not use your email address for any purpose other than correspondence regarding these arrangements.

Additional Information(Required)

Document Upload

Please upload the following documents:(Required)

1) Will – The page showing executorship and last page showing witness signatures
2) 2 pieces of Identification (Birth certificate, Passport, Driver’s Licence, BC ID)
3) SIN (Social Insurance Number)
4) Care Card aka Health Card – front and back (sometimes listed on back of BC ID card)
5) Recent photo (to help us identify and/or prepare for viewing)

Drop files here or

Accepted file types: jpg, png, pdf, doc, docx, jpeg, Max. file size: 256 MB.

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At-Need Form

At-Need Form

Personal Information

Executor/Next-of-Kin Information

Document Upload