Pre-Plan Your Services - Lietz-Fraze Funeral Home

Please fill out our pre-planning form to get a head start on your service arrangements.

Once this form is submitted our team will be in contact with you soon.

Please note that your information is saved on our server as you enter it.

Pre-planning with us

Your First Name

Your Last Name

Email:

Phone:

Who's this plan for?

First Name

Last Name

Gender

Male

Female

Other

Biographical Information

Biographical Information

Birth Date

Birth Place

Family Information

Family Information

Marital Status:

Married

Single

Widowed

Father's Full Name

Father's Last Name

Mother's Full Name

Address - If Living

Disposition Preference

Have cemetery arrangements been made?

Siblings (Living)

Siblings (Deceased)

Children (Living)

Children (Deceased)

Grandchildren (Living)

Grandchildren (Deceased)

Great-Grandchildren (Living)

Great-Grandchildren (Deceased)

Education & Work

Education & Work

Highest Level of Education

School Name

School Location

Occupation

Years at Company

Military Service

Military Service

Military Service options

Yes

No

Branch of Service

Years Served

Interested in Honors?

Yes

No

Funeral Ceremony Options

Visitation Options

options

Visitation at funeral home

Visitation at a custom location

I do not wish to have visitation hours

Funeral Ceremony Options Title

Funeral Ceremony Options

Funeral Ceremony Options

Funeral ceremony at funeral home

Funeral ceremony at a custom location

I do not wish to have a funeral ceremony

Reception options

Reception Options

Reception options

Reception at funeral home

Reception at a custom location

I do not wish to have a reception

Not sure

Would you prefer a burial or a cremation?

Would you prefer a burial or a cremation?

Would you prefer a burial or a cremation?

Final Disposition

Final Disposition

Final Disposition

Ground Interment (burial)

Mausoleum Entombment (above ground burial)

Columbarium (for cremation urns)

Ashes returned to family

Free Text

Would you prefer to include a graveside/committal service?

Would you prefer to include a graveside/committal service?

Yes

No

Ceremony Requests

Ceremony Requests

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

New Field:

Plan Ahead

Pre-planning with us