Legacy Funeral Home ā€“ Family Intake Form
LegacyFuneral Home & Cremation Services

135 South 15th Avenue, Laurel, MS 39440

601-699-4440

[email protected]

Supporting Families & Honoring Lives
While Leaving A Lasting Legacy

šŸ’¾ How to Save Your Progress

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Vital Statistics

Decedent's personal & demographic information

Personal Information
Death Information
Demographics
Family Background
Employment & Education
Veteran Information
Informant / Contact
Personal Interests ā€” For Office Use

Obituary Information

Part 1 of 2 ā€” Basic info & service details

Deceased Information
Service Information (Completed by Funeral Home)

Filled out by Funeral Home

Filled out by Funeral Home

Biographical Information

Obituary Information

Part 2 of 2 ā€” Memberships, survivors & additional details

Memberships & Interests
Survivors
Sons
Daughters
Brothers
Sisters
Form Completion

Service Details

Documents, clothing & family representative

Documents Provided
Clothing Provided
Family Representative ā€” Required to Submit āš ļø

These 4 fields are required before you can submit the form.

šŸ•Šļø

Thank You for Trusting Us

Your information has been received by Legacy Funeral Home & Cremation Services. Our Funeral Director will be in touch with you shortly. During this difficult time, please know that we are here for you every step of the way.

Supporting Families & Honoring Lives ā€” While Leaving A Lasting Legacy

Family Intake Summary

Legacy Funeral Home & Cremation Services  |  Jamera R. McDonald, Director

Optional ā€” for your personal records only. Your information has already been saved.

āš ļø Need to Make a Change?

This form cannot be edited online once submitted. All corrections must be made by contacting Legacy Funeral Home & Cremation Services directly:

šŸ“ž Call: 601-699-4440

šŸ  Visit: 135 South 15th Avenue, Laurel, MS 39440

āœ‰ļø Email: [email protected]