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On-line At Need Form

On-line At Need Form

Thanks for taking the time to fill out our At Need Form. By completing the following information at your own convenience, you should find it easier to provide correct information and have some time to think about the type of services you desire.

The information provided on this form will help Edward Lawrence Funeral Home complete the death certificate and other required documents. In addition, this information will assist the funeral director to better understand your initial wishes. Relaying required statistical information can be time consuming. Our desire is to help expedite the final arrangement conference at the funeral home and make the process a little more comfortable

Please complete (as much as possible) the information on the form and select Submit Information at the end to send the information to us. You may also print out the form and bring it with you to the arrangement conference or fax.

If you'd prefer, a printer-friendly version of this form is also available for you to download and fill out manually. Please see the bottom of this page for further instructions and the download link, if interested.

If you have any questions whatsoever, please contact Edward Lawrence Funeral Home at: (203) 655-6127

* denotes a required field

 

Deceased Vital Statistics for Death Certificate

 

 
 

 

PLACE OF BIRTH:

 

EDUCATION

 

 

 

 


Type of Disposition

 

 

 


Preparation and Viewing


Important Note: Viewing of the body is a choice of the family. In most cases, embalming is required or recommended for public viewing/visitation, mausoleum entombment, or transfer of remains via common carrier (i.e. shipment by air or rail). When possible, the funeral home needs authorization from the next of kin for embalming.

Except in certain cases, embalming is not required by law. Embalming may be necessary, however, if you select certain funeral arrangements, such as a funeral with viewing. If you do not want embalming, you usually have the right to choose an arrangement, which does not require you to pay for it, such as a direct cremation, immediate burial and/or one-time ID viewing for family only. If you elect NOT to order embalming, State law requires refrigeration of an unembalmed body that is held for over 24 hours from the time of death.

 

 

 


Veteran Information

 






Informant/Person In Charge Information

 

 
 
 

Funeral/Memorial Service Information

 

 


Other Information & Instructions

 


At Need Form - Printer-friendly Version

 

You can download the printer-friendly version of the At Need Form to your local computer from the link below. Once downloaded, open the PDF *, and enter your information on the form, then print it out on your printer. You may then either mail or fax it to us at the address or fax number below, or bring it with you when you visit.


Download Printable At Need Form (PDF)

 

* NOTE: Adobe Acrobat Reader software is required to view this file - if you don't already have the Reader installed on your computer, it is available for free from Adobe's website - please click the icon at right to be taken to the download page.

Mail completed forms to the following address:

Edward Lawrence Funeral Home
2119 Boston Post Road P.O. Box 3406
Darien, CT 06820

Please call with any questions: (203)655-6127



 

Edward Lawrence Funeral Home
Phone: (203) 655-6127
Fax: (203) 655-6084
2119 Boston Post Road, Darien, CT 06820


© Edward Lawrence Funeral Home
Crafted with care by Frazer Consultants & TA