Arrangement Details & Vital Information
All fields are optional. Please answer the following questions to the best of your ability. If you do not know an answer or wish to leave it blank, you can move on to the next question.
Are you making immediate arrangements or planning ahead?
If you or your loved one went by a nickname, preferred name, or shortened name
Surname at birth prior to marriage (used for official vital records registration)
Needed for the Ontario Statement of Death
Start typing address for Google Places auto-fill, or enter details manually
Month, day, and year of birth
City, Province or Country of birth
Month, day, and year of passing
Hospital, Hospice, Long-Term Care, or Residence
Required by Ontario for official Death Registration and Canada Pension Plan (CPP) filing. Encrypted and strictly confidential.
Primary employer, company, or industry (past or present)
Job title, trade, or role (e.g. Millwright, Nurse, Teacher)
Needed for the Ontario Statement of Death.