First Call Form
*
*
*
Please enter a valid phone number.
*
example@example.com
Descedent Name
*
First Name
Last Name
Will an autopsy be performed?
*
Yes
No
Is this a home call?
*
Yes
No
If you have an immediate need for a home call, please call us at
(864) 466.0100
for fastest service.
Date of Death
*
-
Month
-
Day
Year
Date
Location of Remains
Home
Hospital
Morgue
Medical Examiner
Location Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
At the time of shipping, the remains will be:
*
Casketed
Cremated
Final Destination
Funeral Home
City
State
Country
Other relevant information or questions
Submit
Should be Empty:
