Get in touch

Immediate Need

If a Death Has Just Occurred

Immediate Need Form

Free Text

Personal Information of Deceased

Last Name:

Middle Name:

First Name:

Date of Birth:

Date of Death:

If the passing was not attended by a medical professional, have the Authorities (Police/EMS) been notified?

Yes

Which location would you like to be contacted by?

Free Text

Personal Information of Person Legally Responsible for Disposition

Last Name:

Middle Name:

First Name:

Relationship to Deceased:

Address:

City:

State:

Zip:

Primary Phone Number:

Secondary Phone Number:

Best Time to Reach Via Phone:

Do you have a pre-arrangement on file with us?

If yes, under what name?

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Visit www.prepaidfunerals.texas.gov for information relating to the purchase of pre-need funeral contracts including descriptions of the trust and insurance funding options available under state law.