625 North Road
Coquitlam, BC V3J 1P2
Phone: (604) 936-9987
Fax: (604) 936-6912
Email: info@burquitlamfuneralhome.ca

Office Location

815 Brunette Avenue

Coquitlam, BC V3K 1C5

Phone: 604-936-9987

Fax: 604-468-2575

info@burquitlamfuneralhome.ca


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Pre-Arrange Online
Family Information

All of the fields below are required for arrangement and necessary documentation at the time of death. Once saved, you can access the information through the login at any time in the future to make the necessary changes, print, and/or submit. Once the information is entered, click on Continue at the bottom of the page.

(Please note: Under some state / provincial laws, your signature is required for all arrangement documentation. If necessary, we will contact you to ensure that the process is complete.)

Informant Information
Who are these arrangements for?
Myself
Biographical Information
Marital Information
Spouse's Address (if living)
Mother's Information
Mother's Address (if living)
Father's Information
Father's Address (if living)
Education
Employment
Military Service
Military Service?

If Yes, please provide discharge paperwork.

Cemetery/Disposition

Comments:

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