Colorado Funeral Services

SCI Colorado Funeral Services 7777 W. 29th Ave. - A Wheat Ridge, CO 80033 Please fill out the form below or download, print and mail to the above address.
General Information	* = required field
* First Name:
* Last Name:
Middle Initial:

Address:
City:
State:
Zip:

* Home Phone:
Work Phone:
Cell Phone:

* E-mail Address:

Marital Status	Married Single Widowed

What is your current age?	(For the purpose of calculating a funeral plan estimate)

Service questions
1. Have you pre-arranged your funeral plans?
	Yes No
2. If so, what is the name of the funeral home?

3. If you have not selected a funeral home which of these locations are closest to your home?

4. What type of funeral are you interested in?
	Traditional Cremation
5. If Cremation would you want a memorial service?
	Yes No

Cemetery Questions
6. Have you pre-arranged your cemetery plans?
	Yes No
7. If so, at what cemetery have you made those arrangements?

8. If you have not selected a cemetery which of the following is closest to your home?

9. If you have selected traditional burial which of the following do you prefer?
	Ground Burial Above Ground Mausoleum Entombment
10. If you have selected cremation which of the following do you prefer?
	Above Ground Inurnment (mausoleum or columbarium) Ground Inurnment (burial space or cremation garden) Scattering
11. What type of memorialization do you prefer?
	Upright Granite Marker (standard, custom-design) Flat Bronze or Granite Marker (flush with the ground) Crypt Plaques (mausoleum) Veteran’s Marker (government provided for veterans only) Cenotaph - small bronze plaque(in cremation garden)

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