We appreciate your taking the time to fill out this PrePlanning Form.
We will process your information and reply as soon as possible.
If you have any questions, please feel free to email or phone (905) 358-3513.
We look forward to hearing from you.

Patterson Funeral Home Preplanning Form
Personal Information:
Last Name:
Given Name:
Middle Name:
Social Insurance/Social Security#:
Address:
City:
Province/State:
Country:
Phone:
Postal/Zip Code:
E-Mail
Date of Birth:
Place of Birth:
Vital Statistics:
Marital Status:
Spouse's Full Name:
Spouse's Maiden Name:
Place of Birth:
Spouses Date of Birth:
Father's Name:
Father's Place of Birth:
Mothers Name:
Mother's Maiden Name:
Mother's Place of Birth:
Work Information:
Occupation:
Type of Work:
Company:
Funeral Service Information
Place Of Service:
Service Location:
Address:
Phone:
Place of Visitation:
Religious Denomination:
Place Of Worship:
Lodge / Union:
Person in Charge of Final Arrangements:
Special Instructions:
Flower Preference:
Music
Casket Bearers (6):
Jewelry:
Glasses:
Clothing:
Other:
Disposition Request:
I Prefer:
Cemetery:
Address:
Phone:
Section:
Location:
I have made a last will and testament:     Yes     No
Other Instructions:
Please list any other instructions you may have:
Memorials/Donations:
Please list any Memorials or Donations to Charity that you would like:
Contact Person/Executor:
Last Name:
First Name:
Middle Name:
Address:
City:
Province/State:
Country:
Postal/Zip Code:
Phone:
E-mail:
Options:
Please select one of the options below as to how you wish to be contacted to finalize these arrangements:
Send information about pre-arrangement
Contact me to set an appointment