When it is practical or possible, making funeral arrangements in advance of need can provide the peace of mind that all details have been taken care of in a way that is satisfying to one's self and one's survivors. A family discussion combined with our counsel can assure that everyone involved feels comfortable with the arrangements. Certainly we all would prefer that our loved ones be able to say afterward "I am glad we did" rather than "I wish we had." Pre-planning can help accomplish this goal. Today, making any kind of funeral arrangement involves many choices and decisions. It is helpful to consider all of the options and take time to ask questions before making final decisions about such an important event. It is our intent to help make the entire experience as positive as possible. If you have already completed funeral arrangements and pre-paid with another funeral home, Fischer Funeral Care will honor, accept, and convert that account at ANY time and at no additional cost to you.

You will benefit by setting up a pre-paid funeral. It freezes the funeral home charges at today's prices. The money is placed into an insurance policy, which you own. You may pay in one lump sum, or you can set up monthly payments: 12 months same as cash or 36, 60, or 120 monthly premiums for lower monthly payments.

Please complete all steps below.  (*required fields)

1. Your Information:
*First Name:
*Last Name:
Line 1:
Line 2:
*City: *State:
*Zip Code:
Home Phone: Work Phone:
Cell: Pager:
*2. Who is this Pre-Arrangement for?
Myself Spouse
Father Mother
3. Personal Information for whom funeral is being planned:
First Name:

Middle Name:

No Middle Name

Last Name:

Maiden Name (if female):
Male: Female:
Line 1:
Line 2:


Zip Code:


Inside City Limits?
Yes No
Home Phone:

Work Phone:


Social Security Number:

Date of Birth:

City and State of Birth:

Marital Status:
The Pre-Arranged Spouse's Name:

The Pre-Arranged Spouse's
Maiden Name (if Female):

If Spouse is Deceased: Date of Death
Father's First Name:

If you don't know, please type "Unknown"

Father's Middle Name:

Father's Last Name:
<------If you don't know, please type "Unknown"
Living     Deceased
Mother's First Name:

If you don't know, please type "Unknown"

Mother's Middle Name:

Mother's Maiden Name:
<------ If you don't know, please type "Unknown"
Living     Deceased
Kind of Business worked in:


Immediate Family: Please enter information below:
Children (Please list City/State of Residence):
Brothers/Sisters (Please list City/State of Residence):
Grandchildren (Please list City/State of Residence):
Great Grandchildren (Please list City/State of Residence):
Other significant family or friends (Please list City/State of Residence):
Which church (or religious institution) are you affiliated with: (type in)
4. Additional Information Needed:
Please place obituary in the following newspapers:
Atlanta Journal-Constitution Marietta Daily Gwinnett Daily Post
Other Newspapers:
You may print my age in an obituary:
Yes No

I would like to write my own obituary:

Yes No Later
Preferred Clergy:

Please engage
clergy for me:

Social Activities, Memberships, Hobbies:
Memorial Contributions to:
Flowers may be sent to funeral: Yes
No (will not be accepted)
Donations preferred (flowers accepted)
Graveside funeral Chapel funeral Funeral at my church
Non-traditional or other request
Please explain:

Disposition preference
burial: in ground above ground cremation

Funeral service preference
graveside chapel at my church
other (explain:)

5. Cemetery Information:
(Note: We handle funerals anywhere around the world. )
Cemetery Preference:
(Please fill in the blank with name, city, state):
I already own plots:
Yes No
I Don't Know

If Yes, which section:

I need help with cemetery plots:
Yes No

Do you own a graveliner or vault?:

Yes No
I Don't Know
Dress in clothes?:
Yes No
I Don't Know
Other Special Requests:
6. Additional Preferences:
Veteran of US Armed Forces?:
Yes No
If Yes, please select branch:
Do you want:
US Flag (if Veteran)? Military Honors
Choose a casket NOW Choose a casket LATER
Will you need help with a grave marker/
Let's Discuss Later

Will a passenger limousine
(for family) be helpful ?:

Let's Discuss Later
Death Certificates:

Certified death certificates are needed for the following:
Social Security (if spouse is living); real estate, automobile, or anything you transfer title to (even if joint ownership); life insurance policy; accounts exclusivley in the deceased name; probate a will; stocks and bonds

My estimate of the number of certified death certificates needed is:

7. Communication with Fischer Funeral Care:
I would like to discuss pre-payment (discount offered):  Yes No
E-mail estimated cost to:
Call me to set up an appointment: (We can meet anywhere you wish)

I will contact you when I am ready:
For security purposes, please enter the name of the month after February:

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