Start Time of Need Planning

The following online planning program was created for the ease and comfort of the families we serve.

Many families find it helpful to complete this preliminary information prior to meeting with us at the planning conference. This will give you an opportunity to gather your thoughts, discuss your personal feelings, and complete general information, so that we may spend more of our time discussing the details of your loved one’s life celebration.

Please fill in as much information as you can. Items with red asterisks are required - all other fields are optional. If you are not sure about something, please leave it blank and we can discuss it with you when we meet in person.

Contact Information (Or the person in charge of making arrangements)

* First Name:

* Last Name:

Relationship To Deceased:

* Email Address:

Address:

City:

Zip Code:

* Best phone number at which to reach you:

Do you have an appointment scheduled with one of our staff?YesNo

Decedent Information (This information is needed to complete the death certificate)

* First Name:

Middle Name:

* Last Name:

Race:

Date of Birth:

Place of Birth:

City:

State:

Country:

Date of Death:

City of Death:

State of Death:

County of Death:

If other, please indicate address:

Name of the Place of Death:

Education:

Usual Occupation (most of life, not retired):

Kind of Business:

Company:

Full Name of Surviving Spouse:

If Wife, Provide Maiden Name:

Residence - Street Address:

City/Town:

Country:

Zip Code:

Length of Residence in County:

Father's Full Name:

Mother's Full Maiden Name:

Possible Service Information Basic Thoughts About Possible Services for Deceased

Religious Denomination:

Name of Church (if applicable):

Name of Cemetery (if applicable):

City and State:

Is there an insurance policy on decedent?YesNo

If Yes, Specify Insurance Type:

Other Informations & Instructions

Please list any other instruction or information you would like us to have:

Veteran Information

Was Decedent Ever in the US Armed Forces?YesNo (if no, continue to next section)

Is a Copy of Discharge Papers Available?Yes (if yes, please bring for us to copy)No

Branch of Service:

Survivor Information We will assist you in writing the newspaper notices. Please separate each name with a comma.

CHILDREN

Name:

Name of Spouse:

Relationship:

Street Address:

City:

County:

Zip:

Phone:

SIBLINGS

Name:

Relationship:

Street Address:

City:

Zip:

Phone:

Name of Spouse:

Sibling's Children (Nieces/Nephews of your loved one):

Parents:

Grandparents:

Number of Grandchildren:

Number of Great-Grandchildren:

Upload Photo(s) of Your Loved One:

We know that meaningful ceremonies do not just happen. They are well thought-out rituals that, at least for a day or two, demand your focus and your time. The next step for you in this process is the Planning Conference. Please click the links below to learn more about the basic items that will be important for you to gather and have accessible and to view an agenda for the Planning Conference.

Remember, this planning needn’t be a burden if you keep in mind that the energy you expend now to create a personalized, inclusive ceremony will help you and other mourners in your grief journeys for years to come.

If you should have any questions, please do not hesitate to contact the funeral home at (217) 544-4646.

Agenda and Important Items for the Planning Conference

PLEASE NOTE : The information supplied through this Web site does not qualify as service arrangements with our company.

Boardman-Smith Funeral Home | (217) 544-7461
800 S. Grand Avenue West, Springfield, IL 62704