At Heritage Funeral Home, our experienced Family Service Representatives are trained to assist in planning services for all denominations and can help you with the questions you might have, such as whether you want a simple or elaborate celebration? Do you want a private or public viewing or the deceased? What readings, musical selections, pictures or displays would you like to reflect your loved one's life? Whatever your decisions are, it is comforting to know you have a funeral professional that will give you caring, personal attention.

As you can see, planning a funeral involves many choices and decisions. That is why we encourage you to make your plans in advance. Pre-planning allows you to choose the type of service and merchandise you desire, and it relieves your family of the burden of making difficult decisions at a very stressful time. The price of funeral services and merchandise has tripled in the past 15 years. However, by pre-paying you can guarantee the price of the funeral service, no matter how long you live. We have many convenient ways for you to fund your funeral plan. Remember, this is one of the best gifts a person can give to his or her family.  

 Your Family Service Representative is here to help you with any and all concerns or questions you may have. Please feel free to contact us at Heritage Funeral Home and Crematory. We are always available to answer your questions.

Heritage Funeral Home and Crematory - "Simply The Best, For Less."
Personal Information
Full Name :
Marital Status : SSN # :
Date of Birth : Birth City / State :
Race : Hispanic / Haitian Origin :
Toledo, Ohio : (year) From : (City / State)
Residence Address :
City : State :
County : Zip :
Phone : E-mail :
Spouse's Name : Spouse's Maiden Name :
Spouse's SSN# : Place of Marriage :
Date of Marriage : Father's Name :
Mother's Name : Mother's Maiden Name :

Work/Education History
Education(0-12) : College 1-5+ :
Occupation :
Business : Company :

Military Record
Branch of Service : Serial Number :
Date Enlisted : Rank At Discharge :
Date Discharged : Discharge On File At :
Copy of Discharge Papers :     Yes     No
Name Of Wars :

Funeral Service Request
Place Of Service :
Church/Other :
Address : Phone :
Place of Visitation :
Religious Denomination :
Place Of Worship :
Lodge / Union :
Person in Charge of Final Arrangements :
Address :
City : State :
County : Zip :
Phone : E-mail :

Special Instructions
Flower Preference :
Music :
Casket Bearers (6) :
(leave blank if funeral
staff to perform) 		1.
2.
3.
4.
5.
6.
Jewelry :
Glasses :
Clothing :
Other :

Disposition Request
I Prefer:
Cemetery :
Address : Phone :
Property Description:
I have made a last will and testament:     Yes     No
Location :

Memberships/Affiliations

Other Instructions

Memorials/Donations To Charity

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