Immediate Need Form

We Are Here for You

This page is the right place to begin in navigating the very recent loss of a loved one.  

If your loss has just occurred, we encourage you to call us directly at (845) 359-0172. In these first hours, speaking with one of our compassionate professionals can provide reassurance, clarity, and steady guidance during what can feel like an overwhelming time. 

Please know that the information requested in this form can just as easily be shared over the phone or emailed, whichever approach feels most comfortable for you. We are here to walk with you, every step of the way.

The Next Steps

The information provided on this form will help us complete the death certificate and other required documents. Our wish is to expedite the final arrangement meeting at the funeral home and make the process a little more comfortable. 

Please complete the online form below to the best of your ability, using the "Submit Information" button at the end to relay the form to us. You may also print out the form and bring it with you to the arrangement conference. If you have any questions at all, please call us. We are here to serve you and your family in this difficult time.

Contact Information

Will you be responsible for making arrangements?

Deceased Information

Gender

Marital Status

Birth Information

Death Information

Where did the death occur?

Work Information

Please remember to bring in original copies of Social Security Card, Birth Certificate and Marriage Certificate.

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