Helpful Information at Time of Death

Record of Vital Information Form

Not everyone feels comfortable transmitting their personal information over the internet. If you would prefer, you may print this form, fill it out, and give it to the person who will be responsible for making your funeral or cremation arrangements. This form was prepared to help provide a single source document of all your essential personal information and advanced planning data to assist survivors after death occurs.


You may wish to complete more than one copy of this form and you may wish to give your funeral director a copy for his/her files. Your family or friends should know where you have placed this information. Do not lock the only copy in your safe deposit box.

We suggest that you discuss your wishes in detail with your family and your funeral director who will provide careful counseling as a public service, with no obligation.