Funeral Planning Wishes

Complete this form, make photocopies, and share it with family and loved ones. Remember, your responses are neither right nor wrong. They just represent your wishes at the date noted, and you can always make changes.

My name ___________________________________ Age __ Today's date _ I acknowledge that funeral planning requires a beginning, and perhaps this is a place to start. I have chosen Davis Funeral Chapel, 531 Shawnee Street, Leavenworth, KS 66048 as my funeral home. I visualize an expenditure of $______________being adequate for my funeral, with funding likely corning from: My Life Insurance, Insurance Company ________________________________Policy #____________________ My family___________________________________________ I don't yet know. I prefer as a funeral choice: Cremation Body burial, embalming Natural burial Body donation I prefer visitation at: Davis Funeral Chapel The ____________________church No visitation I prefer a funeral ceremony at: Davis Funeral Chapel The church The burial site No funeral ceremony A plot for my remains exists at _________________________________________ Cemetery. or No plot currently exists for my remains, but I would like to be at_________________ Cemetery. I prefer direct cremation and Davis Funeral Chapel Crematory is my choice. I have been accepted to a medical school willed-body donation. My body should be directed taken to The University of Kansas Medical Center. I wish to share this preliminary planning document with: My spouse or significant other _ My children, numbering __ 1. 2. 3. 4. My attorney _____________________________________________________________________ My church and clergy member ______________________________________________________ Davis Funeral Chapel Courtesy of Davis Funeral Chapel, 531 Shawnee Street, Leavenworth, KS, 66048 (913) 682 5523