Immediate Need

Immediate Need Form

The information below helps us begin the required paperwork, start the registration process with Vital Statistics, and take the first steps in supporting your family with professional, personalized care. If you’re unsure about any details, simply enter “UNKNOWN.”

Please complete the form and click "SUBMIT" to send it directly to our team.

If you are looking to make Pre-Planning arrangements in advance for yourself or a loved one, please use this form instead.

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Please note that the required Social Insurance Number and Provincial Care Card Number can be provided over the phone, if preferred.

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VITAL STATISTICS INFORMATION

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*Required Fields: must be completed to submit the form. If the information is not known or to be determined, please enter 'unknown' or select from the drop-down menu.

Full Name:

Full Maiden Name

Full Address:

Place of Birth:

Date of Death:

Facility of Death:

Personal Health Number (PHN):

Social Insurance Number (SIN):

Occupation (before retirement):

Date of Birth:

Business Type:

Marital Status:

Spouse's Name (including Maiden):

Father's Name:

Father's Place of Birth:

Mother's Name (including Maiden):

Mother's Place of Birth:

Type of Service:

Viewing:

Disposition:

Urn Preference:

Casket Preference:

Cemetery Name (if applicable):

Height (approximate):

Weight (approximate):

Jewelry:

Pacemaker:

Communicable Disease:

Nuclear Medicine Recipient:

Would you like to be invited to our Cadence Estate Settlement Program? ($195.00)

Number of Death Certificates ($27):

Were Pre-Arrangements Made?

Memorial Society of BC Member?

Next of Kin / Contact Person:

Complimentary Online Obituary

Capture Digital Fingerprint?

DNA Sample with Securigene ($450+) https://www.securigene.com/dna-banking/post-mortem-dna-banking-capsule/

Relationship:

Is This Person the Executor?

Next of Kin/ Contact Person Number:

Next of Kin/ Contact Person Email Address:

Next of Kin / Contact Person Full Address:

Notes & Instructions:

Please select one of the options below:

Phone number for follow up:

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Immediate Need Form

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