My Wishes
Just print out page and complete
Date: ______________
Name: ____________________________________________________________
Note your choices as completely as possible. Use available space to note funeral homes, locations and other spefic instructions. Attach with other funeral documents. Share your wishes (or document location) with your family.
Designated Agent for Body Disposition:
Name: __________________________________ Phone #:___________________________
The right to control final disposition is routinely given to the “next of kin”. You may choose another person as your designated agent. MO/KS residents; document your choice on your Durable Power of Attorney form. It must include specific language giving the agent authority to make decisions regarding the disposition of remains.
Direct Cremation: ___ No Services
Cremation with:
Immediate Burial: ___ No Embalming - No Service
Burial with Services:
Casket Preferences:
Other: ________________________________________________________________________________________
Cemetary Preferences:
Other: ________________________________________________________________________________________
Marker:
Inscription: ___________________________________________________________________
Full Body Donation: Arrangements made with ________________________________________
Home Funeral: _____________________________________________________________________________
Favorite Music or Readings to include in Ceremonies: _______________________________________________
Notes for Obituary: (employment, community service, achievements, hobbies, memorial donation suggestions ons)
