A member of our staff may have directed you here, or you are faced with caring for a loved one who has very recently passed away, and feel this is the right place to start. But we'd like to say this... If you've experienced such an immediate loss, we want you to call us now at (864) 862-2362 In Fountain Inn or (864) 984-4506 In Laurens SC. Connecting with one of our caring professionals, who can guide you in these first hours after loss, can be very comforting. You may be directed to return here during this initial conversation, but much of the information we can glean from this form can also be learned during a personal phone call, or at the arrangement conference.
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 conference at the funeral home and make the process a little more comfortable. Please complete the on line 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 often stressful time.
Deceased Vital Statistics for Death Certificate
* First Name:
* Last Name:
Middle Name:
Sex:
If Wife, Provide Maiden Name:
Residence - Street Address:
City/Town:
Inside City Limits:
Type of Disposition
Disposition Will Be:
City:
State:
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.
The Family Preference Regarding Viewing/Embalming Is:
I Authorize Beasley Funeral Home To Embalm:
Veteran Information
Was Decedent Ever In the US Armed Forces?:
Yes No (if no, continue to next section)
Branch of Service:
Date Enlisted:
Date Discharged:
Honorable Discharge:
Yes No
Military Serial Number:
Is A Copy of Discharge Papers Available?
Yes No (if no, please bring for us to copy):
Informant/Person In Charge Information
* First Name:
* Last Name:
Relationship To Deceased:
* Email Address:
Address:
City:
State:
Zip Code:
Telephone Number:
Funeral/Memorial Service Information
Preferred Place of Service:
Religious Denomination:
Other Information & Instructions
Please list any other instruction or information you would like us to have:
Immediate Need Form - Printer-friendly Version
You can download the printer-friendly version of the Immediate Need Form to your local computer from the link below. Once downloaded, open the PDF *, and enter you 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.
» CLICK HERE to download the form - choose to, 'Save to Disk,' in the dialog box that appears (download times will vary depending upon connection.)
* 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 this address:
Beasley Funeral Home 205 Knight St Fountain Inn, South Carolina29644