Immediate Need

If a Death Has Just Occurred

Greater Victoria, BC Region - Sooke to Sidney

Immediate Need Form

Your Informaiton

Your Information

First Name*

Middle Name

Last Name*

Relationship to Deceased*

Phone Number

Email Address*

Street Address

City

State/Province

Zip/Postcode

Last Will & Testament

Last Will & Testament

Is There A Will?

Yes

Not Sure

Who is named as Executor?

Their Phone Number

Deceased Information

Deceased Information

First Name

Middle Name

Last Name

Deceased Maiden Name

Gender

Father's First Name

Father's Last Name

Father's Birthplace

Mothers First Name

Mother's Last Name

Mothers Maiden Name

Mothers Birthplace

Social Insurance Number

Healthcare Number

Doctors Name

Date of Birth

City

Province / State

Country

Date of Death

Place of Death

Marital Status

Spouse's First Name

Spouse's Last Name (Include Maiden name if applicable)

Deceased Address

City

State / Province

Postal / Zip Code

Country

Occupation of Deceased:

Industry:

Does the deceased have a pacemaker?

Has the deceased undergone radioactive therapy?

Height of the deceased?

Weight of the deceased in pounds?

Comments

Free Text

Additional Information

Will there be a viewing of the body prior to cremation?

Do you wish to purchase a Closing Affairs Estate Settlement?

Free Text

Do you wish for us to take a fingerprint of your loved one so that you can consider selecting a memorial keepsake item at this link: Eternity’s Touch in the future?

Fingerprint/Eternity's Touch

Free Text

Do you wish for us to take a cheek swab for DNA testing purposes? You may see the DNA testing available by clicking here. We will send you a price list by email.

DNA Cheek Swab

How many original death certificates does your estate require they are 27$ each with no tax, we recommend 2 unless the deceased had multiple pensions form outside of Canada or life insurances