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Send Flowers
About Us
Locations
Contact
Home
Tributes
Send Flowers
Pre-need Form
Direct Cremation
Ceremony Pricing
Merchandise
Services
Send Flowers
Direct Cremation
Overview
Service Descriptions
Immediate Need Form
Immediate Need Form
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Please tell us who passed away:
First Name of Deceased
Middle Name of Deceased
Last Name Of Deceased
Last Name at Time of Birth
Address
Sex of Deceased
Male
Female
Where and when did the death occur:
Place of Death
City
Year of Death
Month of Death
Day of Death
Person in charge of cremation arrangements: (must be Executor, if no Executor legal next-of-kin) Please provide photo identification
Full Legal Name
Relationship to Deceased
Address
Telephone
Telephone
Telephone
Email
Cremation Information:
Did the deceased have or been exposed to COVID 19?*
Yes
No
Did deceased leave a will?*
Yes
No
*If 'yes,' please forward a copy of first & last page
Full Legal Name of Executor
Is there an objection to cremation by the executor or immediate family?*
Yes
No
If Yes please explain
Did the deceased leave written direction about being cremated?*
Yes
No
If Yes please explain
Did the deceased have a pacemaker?*
Yes
No
Did the deceased receive any radioactive implants?*
Yes
No
Did the deceased have any infectious or contagious diseases?*
Yes
No
Did the deceased have any GTN patches (Glyceryl Trinitrate - commonly used for angina)?*
Yes
No
Approximate Height of Deceased
Approximate Weight of Deceased
Jewelry to be removed?*
Yes
No
If Yes please list all
Who is authorized to pick up cremated remains at the Crematorium
Information about deceased:
Year of Birth
Month of Birth
Day of Birth
City of birth
Province of birth of Deceased
Country of birth of Deceased
Relationship Status of Deceased
Single
Married
Widowed
Divorced
Common-Law
First Name of Spouse or Partner
Middle Name of Spouse or Partner
Last Name of Spouse or Partner Before This Relationship
Parent 1 Birth Name
Parent 2 Birth Name
Parent 1 Place of Birth
Parent 2 Place of Birth
Dec - Type of work done during most of working life
Dec - Type of business or industry
Is the deceased eligible for coverage by ODSP or Social Services?*
Yes
No
Dec Gov Assistance
Urn (as chosen from our Merchandise page)
Urn engraving¹*
Yes
No
Expedited Cremation¹*
Yes
No
Cremated remains delivery¹*
Yes
No
Identification of Deceased¹*
Yes
No
Witnessing cremation¹*
Yes
No
We provide 10 proof of death certificates (Require more? Additional fees apply)*
Yes
No
¹Additional fees apply
How many additional death certificates?
How did you hear about Aftercare?
Location Information
Location
Aftercare Toronto
Aftercare Oshawa / Whitby
Notes / Comments
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