site image

Arrangement Form 

We are very sorry for your loss and stand ready to assist you in your time of need. If you have not already scheduled a meeting with us, please call us.

Use this form to provide us with the details of the person who has passed and the legal next-of-kin. Please provide us with the information required to submit this form in as much detail as possible. 

**Before submitting your information, please review our General Price List for disclosures for the services we offer located under the price lists tab at the top of this page.**

Arrangement Details

Personal Information

Please use the area above to enter the names of siblings, children and grandchildren.

Work/Education History

Military Record


Next-of-Kin information

Funeral Service Request

Disposition Request

(if applicable)
(if applicable)
(if applicable)

Summary Details

© 2019 Bailey Funeral Home and Cremation Service, PA. All Rights Reserved. Funeral Home website by CFS