Our Pre-Planning Form

You may think that pre-planning your funeral is a daunting task, but really it doesn’t take as long as you might think to pre-plan your future service online. Our online pre-planning form will easily guide you through the process. One question at a time. Until you’ve created a plan that feels just right for you. Your time completing this form now can save your loved ones hours and hours of extra grief in the future. So you’re invited to start filling in the blanks. And pretty soon you’ll have a perfect picture of what you’d like your final and lasting event to look like.

Basic Information

First Name

Middle Name

Last Name

Choose your closest location:

Closest Location

What is your relationship to this person?

Choose this person's gender:

Relationship

Gender

Male Female

Additional Information About You

First Name

Middle Name

Last Name

Daytime Phone

Evening Phone

I would like to be contacted to discuss Pre-Planning:

Contact to Discuss

Yes No

Biographical Information

Birth Date

Birth Place

Family Information

Marital Status:

Marital Status

Married Single Widowed Divorced

Father's Name

Father's Address (if living)

Mother's Name

Mother's Address (if living)

Siblings (Living)

Siblings (Deceased)

Children (Living)

Children (Deceased)

Grandchildren (Living)

Grandchildren (Deceased)

Great Grandchildren (Living)

Great Grandchildren (Deceased)

Education & Work

Highest Level of Education

School Name

School Location

Occupation

Company

Military Service:

Military Service

Yes No

Options

Visitation Options

Funeral Service Options

Visitation Options

Visitation at our funeral home Visitation at another location (indicate below) I do not wish to have visitation hours.

Funeral Service Options

Funeral service at our funeral home Funeral service at another location (indicate below) I do not wish to have a funeral service.

Visitation - Other Location

Funeral Service - Other Location

Reception Options

Would you prefer burial or cremation?

Reception Options

Reception at our funeral home Reception at another location (indicate below) I do not wish to have a reception.

Burial or Cremation

Burial Cremation

Reception - Other Location

Final Disposition

Would you prefer to include a graveside/committal service?

Final Disposition Options

Ground Interment (burial) Mausoleum Entombment (above ground burial) Columbarium (for cremation urns) Ashes returned to family

Graveside Service

Yes No

Almost done...

Please list any musical selections you would like to include in your services.

Musical Selections

Please list any poems, religious texts, or readings you would like to be read at your services.

Readings

Please list any interests or hobbies you would like to include into your services.

Interests/Hobbies

Please list any special themes you would like to include in your services.

Special Themes

Please list any specific foods or beverages you would like to make available to your family and guests at the services.

Food/Beverages

Is there a special story, personal thank you, or message of hope you would like to be read during your services?

Special Message

Douglas Chapel*
2189 Midway Road
Douglasville, GA 30135
(770) 942-2311
info@jones-wynn.com

Villa Rica Chapel
306 Westview Drive
Villa Rica, GA 30180
(770) 459-3694
info@jones-wynn.com

Meadowbrook Memory Gardens
1100 Hickory Level Road
Villa Rica, GA 30180
(770) 459-6494
meadowbrookmemorygardens.com