Funeral Directors Service Request
FOR FUNERAL DIRECTORS ONLY!! This form uses SSL encryption for the security of the Veterans' information. IMMHG has recently updated this form, please select the correct responses and dates. PLEASE SELECT THE SUBMIT BUTTON ONLY ONCE !!
  • Last 4 of members SSN ####
  • Contact Information of the Onsite Director on the day of the service as accurate as possible.
  • Contact Funeral Director
  • - -
    Contact Funeral Director
  • - -
    Please provide number of the actual onsite service representative.
  • If your Funeral Home is not listed, select the entry "OTHER LOCATION" and enter the Name and Address along with the Phone Number in the Special Request area after the Obituary.
  • PLEASE NOTE THAT THE NEW NATIONAL CEMETERY AT CROWN HILL IS OPEN. If Service Location or Cemetery is not listed, select the drop-down (OTHER) and enter the location in the Special Request area after the Obituary on this form. Please use commas as the line spacer rather than paragraph returns.
  • Full Team includes ALL options. Please Select ONE choice. Each ceremony includes a Flag folding either by Active Military or IMMHG.
  • / / :
    Enter the date and time of the services at the above location.
  • :
    Enter here the approximate time that the Military Honors portion of the service is to take place. IMMHG normally arrives 30 minutes prior.
  • Have you requested service members branch be present at this service?
  • Enter the mission number assigned by the military if or when you speak with them.
  • Rank is helpful for IMMHG to provide the appropriate level of service, especially in retirees.
  • Check all that apply.
  • How are the remains presented at the service?
  • Will there be a US Flag present for the service?
  • County where the military portion of the service is to take place.
  • Copy and paste the web address for the obituary
  • Copy and paste the obituary into this area.
  • Please enter here any information that would be helpful for the IMMHG team and the Military to know in fulfilling your request for services. Please use commas as the line spacer rather than paragraph returns.
  • Choose the name of the file that is the scanned image of the deceased's DD 214 or Certificate of Honorable Discharge or VA card. Must be a .gif, .jpg, .jpeg, or .pdf file type.

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