Thoughtful Service, Sincerely Rendered Since 1926.
Thoughtful Service, Sincerely Rendered Since 1926. Thoughtful Service, Sincerely Rendered Since 1926. Thoughtful Service, Sincerely Rendered Since 1926. Thoughtful Service, Sincerely Rendered Since 1926. Thoughtful Service, Sincerely Rendered Since 1926. Thoughtful Service, Sincerely Rendered Since 1926. Thoughtful Service, Sincerely Rendered Since 1926. Thoughtful Service, Sincerely Rendered Since 1926.

 

 
 

On-line At Need Form

Thanks for taking the time to fill out our At Need Form. By completing the following information at your own convenience, you should find it easier to provide correct information and have some time to think about the type of services you desire.

The information provided on this form will help Ryan Funeral Home & Crematory complete the death certificate and other required documents. In addition, this information will assist the funeral director to better understand your initial wishes. Relaying required statistical information can be time consuming. Our desire is to help expedite the final arrangement conference at the funeral home and make the process a little more comfortable.

Please complete (as much as possible) the information on the form and select Submit Information at the end to send the information to us. You may also print out the form and bring it with you to the arrangement conference or fax.

If you'd prefer, a printer-friendly version of this form is also available for you to download and fill out manually. CLICK HERE for further instructions and the download link, if interested.

If you have any questions whatsoever, please contact Ryan Funeral Home & Crematory at: (920)336-3171

Deceased Vital Statistics for Death Certificate
* First Name:
* Last Name:
Middle Name:
Sex:
Race:
Date of Birth:
Place of Birth: City:

State:

Country:
Date of Death:
City of Death:
State of Death:
County of Death:
Location of Death:

If other, please indicate address:
Name of the Place of Death:
Education
Usual Occupation (most of life):
Kind of Business:
Company:
Marital Status:
Full Name of Surviving Spouse:
If Wife, Provide Maiden Name:
Residence - Street Address:
City/Town:
Inside City Limits:
County:
State:
Zip Code:
Length of Residence In County:
Father's Full Name:
Mother's Full Maiden Name:

Type of Disposition
Disposition Will Be:
If Cremation, Indicate Preference For Disposition of Ashes?:
Name of Cemetery (if applicable):
City:
State:

Preparation and Viewing

Important Note: Viewing of the body is a choice of the family. In most cases, embalming is required or recommended for public viewing/visitation, mausoleum entombment, or transfer of remains via common carrier (i.e. shipment by air or rail). When possible, the funeral home needs authorization from the next of kin for embalming.

Except in certain cases, embalming is not required by law. Embalming may be necessary, however, if you select certain funeral arrangements, such as a funeral with viewing. If you do not want embalming, you usually have the right to choose an arrangement, which does not require you to pay for it, such as a direct cremation, immediate burial and/or one-time ID viewing for family only. If you elect NOT to order embalming, State law requires refrigeration of an unembalmed body that is held for over 24 hours from the time of death.
The Family Preference Regarding Viewing/Embalming Is:
I Authorize Ryan Funeral Home & Crematory To Embalm:
Name of Authorizing Person:
Relationship To Deceased:

Veteran Information
Was Decedent Ever In the US Armed Forces?: Yes No (if no, continue to next section)
Branch of Service:
Date Enlisted:
Date Discharged:
Honorable Discharge: Yes No
Military Serial Number:
Is A Copy of Discharge Papers Available? Yes No (if yes, please bring for us to copy):

Informant/Person In Charge Information
* First Name:
* Last Name:
Relationship To Deceased:
* Email Address:
Address:
City:
State:
Zip Code:
Telephone Number:

Funeral/Memorial Service Information
Preferred Place of Service:
Religious Denomination:
Is there At Need Funeral Insurance on decedent?: Yes No
If Yes, Specify Insurance Type:
(i.e., Forethought, Purple Cross, trust, etc.)

Other Information & Instructions
Please list any other instruction or information you would like us to have:



At Need Form - Printer-friendly Version

You can download the printer-friendly version of the At Need Form to your local computer from the link below. Once downloaded, open the PDF *, and enter your information on the form, then print it out on your printer. You may then either mail or fax it to us at the address or fax number below, or bring it with you when you visit.

»   CLICK HERE to download the form - choose to, 'Save to Disk,' in the dialog box that appears (download times will vary depending upon connection.)
Get Adobe Acrobat Reader* NOTE: Adobe Acrobat Reader software is required to view this file - if you don't already have the Reader installed on your computer, it is available for free from Adobe's website - please click the icon at right to be taken to the download page.

Mail completed forms to the following address,
or fax them to the number below:

Ryan Funeral Home & Crematory
305 N Tenth Street
De Pere, Wisconsin 54115

Fax: (866)365-7926

Please call with any questions: (920)336-3171


 

 
De Pere and the Greater Green Bay Area
305 N Tenth Street, De Pere, WI 54115
Phone: (920) 336-3171 | Toll-free: (866) 365-7926
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 ryanfuneralhome@ryanfh.com

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Testimonials
  • "Thank you for the wonderful treatment that you and your staff provided for [us]. Your professionalism and honest concern are exemplary! We have received many compliments from our friends as to the quality of the entire event. Even more important to me is how well you helped us through this most difficult time."
    P.D.
  • "As things start to return to some semblance of normal, I cannot help but reflect on all I've been through in this last month. I would feel extremely remiss if I didn't take the time to thank you personally, but also your staff, for the wonderful service you provided for my family and myself. I want you to know that from the very first I knew that everything was going to be okay… not just in a so-so manner, but in an exemplary manner. My confidence in [Ryan Funeral Home] was well founded. Thank you for doing the wonderful job you do. I truly appreciate it."
    K.V.
  • "Thank you so very much for the kind and compassionate care you gave to our family upon the death of our mother. From the moment [you] met us at Rennes Health Care… through the day of the funeral, all of you demonstrated the utmost professionalism, while at the same time showed genuine care and concern for our family and for mom. May God bless you and give you the strength to continue providing the excellent and compassionate service that we were so fortunate to have received. "
    D.B.
  • "Thank you just doesn't seem enough for all you have done for me and my family during this most difficult time. I can't believe how hard my mother's death has hit me. I can't tell you how beautiful you made my mom's service."
    R.O.
  • "Your comfort, presence, and all the love you gave to us; it helped a lot to be able to get over the first shock of Dad's passing. Thank you just doesn't seem to be enough, but it comes with a lot of love to you and your wonderful staff."
    L.R.