CONTACT US

Contact Us

Elgin Funeral Home

Contact Us Form

If a Death Has Just Occurred

First, let us express our deepest sympathy for your loss and know we make ourselves wholly available to you and your family during this difficult time. You may call us at 1-512-281-5697 day or night; the phone is always forwarded to our personal cellphone after hours. One of our caring staff will bring your loved one into our care and set a good time for you and your family to sit down and begin helping you put one foot in front of the other.

Immediate Need Form

Free Text

Personal Information of Deceased

Last Name*

Middle Name*

First Name

Date of Birth*

Date of Death*

Time of Death*

Social Security Number*

Free Text

Preparation Information

Has a Doctor / Coroner Been Notified?

Yes

If Deceased Passed at Home, Do You Permit Us to Embalm the Body?

Yes

Has the Body Been Released for Removal?

Yes

Do You Permit Us to Cremate the Body?

Yes

If Yes, Who Has Granted Permission?

Free Text

Physician Information

Name of Doctor Signing Death Certificate*

Email Address*

Business Telephone*

Street*

City*

State/Province*

Zip/Postcode*

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Personal Information of Person Legally Responsible for Disposition

Last Name:

Middle Name:

First Name*

Relationship to Deceased*

Street*

City*

State/Province*

Zip/postcode

Primary Phone Number*

Secondary Phone Number*

Best Time to Reach Via Phone*

Do You Have a Prearrangement on File with Us?

If Yes, Under What Name?

Harris - Nadeau Mortuary Template - Official

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A Year of Grief Support

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CONTACT US

Contact Us

Elgin Funeral Home

Contact Us Form

Immediate Need Form

A Year of Grief Support

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