Funeral Assistance Request

Our Preferred Provider Network of funeral homes, cremation services, and cemeteries enables us to offer you assistance if a death has occurred (or is imminent) or if there is a need to transport human remains between cities. We need certain information to determine how to assist you. We understand that a prompt reply is needed. Please complete the following form and we’ll get back to you just as soon as possible.

Your Contact Information

First Name:^*

Last Name:^*

Phone Number:^*

Email Address:^*

Your Relationship to the deceased:^*

Information About the Deceased

Full Name of the Deceased:^*

Next of Kin:^*

Type of Interment Needed:^*

Type of Service Needed:^*

Location of the Deceased. Provide the current location of the remains including city, state, country, and the facility (for example: hospital, nursing home, morgue, funeral home, etc.):^*

Transportation. If the deceased needs to be transported to another location provide the city, state, country where the remains will be shipped to. Also note if the remains are a human body or cremation ashes:^*

Funeral Home. If a funeral home has already been engaged or contacted, provide the funeral home name, address, phone number, and an explanation of the engagement. ^*

International Transportation

If the deceased is currently outside of the United States and will be shipped back to the United States, please provide the following additional information.

Reason the deceased was outside of the U.S.

Are family members currently with the decedent?

Has the U.S. consulate been contacted?

Additional Information

Provider any additional information regarding your request.

Funeral Assistance Request

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