HUCKLEBERRY CREEK Arrangement Form

WELCOME to our innovative Cremation Arrangement Form. If a loved one has just passed or is near death, then this Arrangement Form should help make the process a little bit easier. If you are wanting to plan ahead for the future then click here to visit our FUTURE PRE-PLAN FORM. Please notice that we ask you to answer questions that may not pertain to your situation so as to be very clear about your expectations for our services. The various inputs below that have a red star must be answered to complete the process. Please don't hesitate to call with any questions or concerns. (360) 868-2594.

NOTE: If your loved one is located at a Coroner/ME, Hospital, or another funeral home then payment is required before we transport your loved one to the crematory. However, if your loved one is located at a residence, then we will pickup and transport to the crematory upon receiving your call. In this case, the payment and arrangments can be made after we have already transported to the crematory.

FAMILY CONTACT INFO

Select Timing of Need*:

Name of Decedent*:

Name of Person Making Arrangements*:

Relationship of Person Making Arrangements*:

Phone Number*:

Email*:

CREMATION PACKAGE

GPL Acknowledgment*:

SIMPLE CREMATION PACKAGE Includes:

Removal & Transport of your Loved One (less than 300lbs) from another FH, Hospital Morgue, or Coroner/ME in our 9 County Service Area. Includes King, Kitsap, Lewis, Mason, Pierce, Thurston, Grays Harbor, Jefferson, and Pacific Counties.
NO Extra Mileage or Transportation Fees.
Refrigeration and Sheltering
Filing the death certificate, notifying SSA
Cremation
Black plastic urn
Complimentary Secure Mailing of the Urn in WA, USPS Priority Express

Does not include any government fees or any other other product or service not listed here.

Select Cremation Package*:

Select Decedent Weight*:

What county are we picking up the decedent?*:

Location where we'll be picking up the decedent?*:

Name & Address of Location (If known):

Transport (Outside Primary Service Area):

Viewing Acknowledgement*:

Select Rush Cremation*:

IMPORTANT NOTE: The timing to obtain a Cremation Permit from the Health Department is out of our control. It can take a week or more for Medical Certifier and the government to complete their part in the online system. We are often simply waiting for the permit or waiting for the family to complete their required authorizations. Once we receive the permit and the authorizations from the family we can proceed with the cremation. A "RUSH" Cremation is completed 2-4 Business Days after we receive the permit and authorizations. A "PRIORITY RUSH" is completed the Next Business Day after we receive the permit and authorizations.

Take Fingerprint for Jewelry*:

Take Locket of Hair*:

Splitting Remains*:

Additional Instructions for Splitting:

Instructions for Returning the Cremated Remains*:

Instructions for Returning Personal Effects*:

IMPORTANT NOTE: When we bring your loved one into our care, we sometimes also receive Personal Effects such as a watch, jewelry, clothes, glasses, etc. If the Personal effects are clothing or linens then they will be disposed of or cremated. Non-clothing items will not be cremated with the deceased without specific consent in writing.

Name & Address for Shipping Cremated Remains and Personal Effects:

URNS & KEEPSAKES (Optional)

Select to Purchase Urn/Keepsakes (Optional)

IMPORTANT NOTE: We only fill urns or keepsakes purchased from our firm. We do not fill urns or keepsakes purchased from other companies. Adding an urn or keepsake here is an optional upgrade. If you do not choose to upgrade the urn then the cremated remains will be placed into the black plastic urn included in the Simple Cremation Package.

Add Simple Engraving:

GOVERNMENT CHARGES

How many Death Certificates?*:

IMPORTANT NOTE: Death Certificates are ordered from the Health Department- Our charge is the exact same, with NO upcharge. Also, If the Cause of Death is currently Pending, we recommend that you only purchase One "Pending" Death Certificate if you need it. Later, when the Cause of Death has been determined and the Coroner or Medical Examiner updates your family (which could be a couple months), then you can contact us to order more Death Certificates at that time.

Instructions for Returning the Death Certificates*:

Name & Address for Mailing DCs:

Required WA State Fee*:

WA State Cremation Fee ($10.80)

What County Did the Death Occur? (County Permit Fee)*:

VETERAN INFO

Complete Flag App & Retrieve US Flag*:

Instructions for Returning the Flag*:

Schedule National Cemetery:

Upload Discharge Paperwork (DD214):

SUPPLIMENTARY

Please Upload a Photo of Your Loved One:

How Did You Hear About Us?*:

Required Family Paperwork To Complete*:

REQUIRED CREMATION PAPERWORK

Instructions: When you click on the links to the forms below they should open in a new window so that you can complete them later- after you have completed this Arrangement Form.

1. DEATH CERTIFICATE INFO FORM- In order to obtain a Cremation Permit from the Health Department, we must submit the death certificate vital information that you provide us. We can not begin a cremation without a permit and we cannot get a permit without this information from you.

2. CREMATION AUTHORIZATION FORM- After we obtain a Cremation Permit from the Health Department, before we can cremate a decedent, we must have the legal authorization from the family to do so. Please complete the Cremation Authorization Form so we can proceed with the cremation after obtaining a permit.

NOTE: If you go beyond the selected time frame then additional charges may incur for use of Refrigeration facilities.

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HUCKLEBERRY CREEK Arrangement Form

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