Immediate Need | Hitzeman Funeral Home and Cremation Services

If you’ve recently experienced a loss, we encourage you to call us at (708) 485-2000 for the quickest assistance. Email inquiries may take longer to receive a response. Once we speak with you by phone, we can begin helping your family right away.

If you’ve already contacted us, please complete this form as fully as you can. Should you prefer not to include a Social Security number, you may enter nine 9’s, and we will gather the correct information with you over the phone or during an in-person visit.

Immediate Need Form

Free Text

Personal Information of Deceased

Last Name*

Middle Name

First Name*

Date of Birth*

Date of Death*

Social Security Number*

Free Text

Preparation Information

Has a Doctor / Coroner Been Notified?

Yes

Free Text

Physician Information

Name of Doctor Signing Death Certificate

Email Address

Business Telephone

Street

City

State/Province

Zip/Postcode

Free Text

Personal Information of Person Legally Responsible for Disposition

Last Name*

Middle Name

First Name*

Relationship to Deceased*

Street*

City*

State/Province*

Zip/postcode

Primary Phone Number*

Secondary Phone Number

Best Time to Reach Via Phone*

Do You Have a Prearrangement on File with Us?

If Yes, Under What Name?

REst easy. We are here to help.

Immediate Help

When you need help most

Immediate Need Form