Print Download End-of-Life Planning Checklist www.FinalWishesKit.com Final Wishes End of Life Planning Checklist Name: Date of Birth: Address: (include street address, town, city, state, province, zip code, postal code) Email Address: Contact Phone Number: I have prepared a Last Will and Testament, and my Will can be found with the following person or at the following location. Details (optional): I would like to donate my Organs and Tissues and (a) I have registered where necessary in my State/Province or (b) I have not registered in my State/Province, or no registration is available, and my wishes are as follows: Details of wishes (optional): I would like my funeral arrangements to be made by the following person(s): Detailed information of persons (optional): I want to be Buried: What would you like to be done with your body? (Example: Buried underground, buried above ground, in a mausoleum, buried at sea) Details (optional): I want to be Cryogenically preserved (frozen): Following institution and details (optional): I want to be Cremated: Details (optional): I already have a pre-arranged funeral plan or funeral insurance program arranged with the following company: Details: I would like to have a funeral service, followed by burial or cremation: Details (optional): I would like to have a funeral service, followed by a graveside service or a service at the crematory, followed by burial or cremation: Details (optional): I would like to have only a graveside service or a service at the crematory, followed by burial or cremation: Details (optional): I would like to have a memorial service or celebration of life after the burial or cremation: Details (optional): I would like to have a funeral service in my own home: Details (optional): I would like to express my preferences for the place of service, celebration of life, crematory, mortuary, and funeral home. Details: I would like to have a viewing before my funeral: Details (optional): I would like to have a wake before my funeral: Details (optional): I would like to have a visitation before my funeral: Details (optional): I would like to have a reception or gathering after my funeral or memorial service: Details (optional): I would like my family and friends to observe my religion’s mourning rituals and customs: Details (optional): In general, I would like the total cost of my funeral to be (e.g., economical, average, above average, or a specific dollar cost range, etc.): Details (optional): I would like the following people to be notified of my death: Details (name, address, phone number, email address, and relationship to me): I would like my funeral arrangements published online and within the following publications/locations: Details: I would like an obituary to be published online and within the following websites and publications/locations: Details (including the following information): I have served in the military, police, or armed forces and I wish to have a funeral or memorial in keeping with the tradition of my branch of service using any available compensation provided by the service: Details: In lieu of flowers, I would like donations by family and friends to the following charities in my memory: Details: I would like a casket or coffin: Details of type/cost of casket and/or if a pre-purchased casket has been arranged: I would like the following persons to serve as my Pallbearers: Details and names of pallbearers and/or honorary pallbearers: I would like the following persons, groups, organizations, and clubs to be notified of and invited to my funeral or memorial service: Details (such as friends, veterans’ groups, alumni associations, sports or hobby clubs, etc.): I would like to have input on my appearance for my final disposition: Details (clothing preference, hairstyle, jewelry) on how I would like to appear for my final disposition, including special items to be included in my casket to be buried or burned: I would like the following floral arrangements at my service or celebration of life: Details of types, color, arrangements: I express the following wishes with respect to religious, musical, or spiritual elements of my service or celebration of life: Details: I would like to have input on the eulogy or last message to friends, family, special persons: Name of the person preferred to give the eulogy. Special or last messages, notes, thoughts, and other information and details: I would like a container for my ashes, and the cost should be limited as follows: Specifics and details: I would like the scattering of my ashes and/or my remains to be buried in a cemetery: Location(s), interment, celebrations, other details: I would like a monument, marker, gravestone, or headstone: Details including if pre-purchased, and where I would like it to be placed: I would like an epitaph or inscription: Details of what I would like to appear (e.g., message, dates, phrase, quote, specific images): I would like there to be a legacy, endowment, or trust created in my name: Details (e.g., park bench, tree planted, web page posting, donation, etc.): Final Notes and Personal Thoughts: Details (optional):