Pre-planning your own or loved one's funeral prior to a death allows you to express your own wishes. It relieves your family of the burdensome and stressful decisions at an emotional time. Pre-planning does not require prepayment; however a prepayment option is available. Concord Funeral HomeSM is in compliance with the Massachusetts Funeral Directing Board rules and regulations in regards to pre-financed funerals. All contracts are filed accordingly to ensure your money is allocated properly. We encourage you to call for an information-only conference to answer any questions. Please remember all questions are important questions.

You can contact us to arrange a time to meet, or you can start the process by completing and submitting this form via our secure server. If you wish for the funeral home to contact you to arrange a meeting to discuss all of your options, please choose the appropriate option at the bottom of the form. If you wish, we can also file the information until you are ready to meet in person.

Please Note: This form should not be used to report a death of a loved one. In those cases, please immediately call the funeral home to make the proper arrangements at 978/369-3388.

Personal Information (Required for Death Certificate) Name:(Maiden)*
Date of Birth:*
Place of Birth*
Home Address:*
Education & Occupation Degrees Held:
Next of Kin/Informant, Name of Next of Kin:*
Next of Kin Address:*
Funeral Service Information: (Please indicate which services you would like.) *
Religious AffiliationPlace of Worship:
Family History (Required for Death Certificate) Father's Name:*
Father's Birthplace:*
Mother's Name:*
Mother's Birthplace*
Date of Marriage:*
Military/Veteran Information if Applicable Branch of Service:
Wartime Service:
Serial Number:
Thank you for filling out this information. Please enter your telephone number and email address below and we will follow up with you to schedule an appointment. All information is confidential. We look forward to meeting with you.

Message and Phone Number:*
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