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COVID-19 ANNOUNCMENT

1-919-775-3535

COVID-19 ANNOUNCMENT

HOME
OBITUARIES
ABOUT US
SERVICES
PLAN AHEAD
GRIEF SUPPORT
RESOURCES

FOR IMMEDIATE ASSISTANCE

1-919-775-3535

Plan Ahead

Online Preplanning Form

Make these important decisions in the privacy of your own home with our simple online pre-planning form.

Online Preplanning Form

Free Text

Personal Information of Deceased

Who is this plan for?

First Name

Middle Name

Last Name

Birthdate

Birthplace (City, State, Zip)

Address (City, State, Zip)

Free Text

About You

Email Address

Phone Number

Free Text

Family, Work, & Education

Free Text

Family Information

Father's Name

Mother's Name

Mother's Maiden Name

Marital Status

Spouse's Name

Spouse's Maiden Name

Free Text

Additional Family Members

Siblings (alive)

Siblings (deceased)

Children (alive)

Children (deceased)

Grandchildren (alive)

Grandchildren (deceased)

Great-Grandchildren (alive)

Great-Grandchildren (deceased)

Free Text

Education History

Highest Level of Education

Free Text

Work History

Occupation

Company Name

Did this person serve in the military?

Yes

No

Branch of Military?

Free Text

Your Wishes

Visitation Options

Visitation at funeral home

Visitation elsewhere:

No Visitation

Funeral Service Option

Funeral service at funeral home

Funeral service elsewhere

No Visitation

Reception Options

Reception at funeral home

Reception elsewhere:

No Visitation

Would you prefer burial or cremation?

Burial

Cremation

Final Disposition

Ground Interment (burial)

Mausoleum Entombment (above ground burial)

Columbarium (for cremation urns)

Ashes returned to family

Would you prefer to include a graveside/committal service?

Yes

No

Free Text

Service Information

Name of Cemetery

Location of Cemetery

Please Answer the following math Question.

Thank you! Your submission has been received!

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CONTACT US

P. 1-919-775-3535

Fax. 1-919-774-7376

E. rpfh@rogerspickard.net

509 Carthage Street

Sanford, NC 27330

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