Care of the Body Preferences Worksheet
1. Print this worksheet.
2. Enter the details about documents and service providers related to care of the body after death.
3. Make copies for your family, or for the person who will take care of these details after your death.
4. Keep the original in a safe location.
Care of the Body Worksheet for: ______________________________
Organ donor
Are you an organ or tissue donor?
Yes___ No___
Which organs or tissues will you donate?
All organs and tissues
Kidneys
Heart
Liver
Pancreas
Intestines
Lungs
Skin
Corneas
Bone and bone marrow
Tendons, ligaments, connective tissue
List details for the organization receiving the organs.
Name of the organization
Phone number to notify them of your death
Email
Address
Deadline for delivery of the body
Donating the whole body to science
Are you donating your whole body to science?
Yes___ No___
Where are the documents confirming the whole body donation?
Original
Copies
List details for the institution receiving the body.
Name of the institution
Phone number to notify them of your death
Email
Address
Deadline for delivery of the body
Funeral home
Have you selected a funeral home?
Yes___ No___
List details for the funeral home.
Name of funeral home
Contact person
Phone number
Email
Address
If no funeral home
List details for the person caring for the body.
Name
Phone number
Email
Address
Cremation of the body
List details for the crematory.
Name of crematory
Contact person
Phone number
Email
Address
Final location of the body or cremains
Have you chosen a location for your body or cremains?
Yes___ No___
List details for the cemetery plot.
Name of the cemetery
Contact person
Phone number
Email
Address
Plot number or description
List details for the mausoleum or family crypt.
Name of the mausoleum
Contact person
Phone number
Email
Address
Crypt number or description
List details for the columbarium or garden niche.
Name of the columbarium
Contact person
Phone number
Email
Address
Niche number or description
Headstone or grave marker for burial
Have you selected a headstone or grave marker?
Yes___ No___
List details for the supplier of the headstone or grave marker.
Name
Address
Phone number
Email
Model number or description of the headstone
Epitaph
Have you decided on an epitaph?
Yes___ No___
Choose the details you’d like included in your epitaph.
Name
Date of birth
Date of death
Place of birth
Place of death
A sentence or phrase
A photograph
A symbol
Other
Memorial society
Are you a member of a memorial society?
Yes___ No___
List details for the memorial society.
Name of the memorial society
Contact person
Phone number
Email
Address
Prepaid expenses
Have you prepaid any funeral or burial expenses?
Yes___ No___
Enter the details for each expense that has been prepaid.
Expense
Paid to
Amount paid
Date paid
Contact person
Phone
Email
Address
Comments
Care of the Body Preferences Worksheet
1. Print this worksheet.
2. Enter the details about documents and service providers related to care of the body after death.
3. Make copies for your family, or for the person who will take care of these details after your death.
4. Keep the original in a safe location.
Care of the Body Worksheet for: ______________________________
Organ donor
Are you an organ or tissue donor?
Yes___ No___
Which organs or tissues will you donate?
All organs and tissues
Kidneys
Heart
Liver
Pancreas
Intestines
Lungs
Skin
Corneas
Bone and bone marrow
Tendons, ligaments, connective tissue
List details for the organization receiving the organs.
Name of the organization
Phone number to notify them of your death
Email
Address
Deadline for delivery of the body
Donating the whole body to science
Are you donating your whole body to science?
Yes___ No___
Where are the documents confirming the whole body donation?
Original
Copies
List details for the institution receiving the body.
Name of the institution
Phone number to notify them of your death
Email
Address
Deadline for delivery of the body
Funeral home
Have you selected a funeral home?
Yes___ No___
List details for the funeral home.
Name of funeral home
Contact person
Phone number
Email
Address
If no funeral home
List details for the person caring for the body.
Name
Phone number
Email
Address
Cremation of the body
List details for the crematory.
Name of crematory
Contact person
Phone number
Email
Address
Final location of the body or cremains
Have you chosen a location for your body or cremains?
Yes___ No___
List details for the cemetery plot.
Name of the cemetery
Contact person
Phone number
Email
Address
Plot number or description
List details for the mausoleum or family crypt.
Name of the mausoleum
Contact person
Phone number
Email
Address
Crypt number or description
List details for the columbarium or garden niche.
Name of the columbarium
Contact person
Phone number
Email
Address
Niche number or description
Headstone or grave marker for burial
Have you selected a headstone or grave marker?
Yes___ No___
List details for the supplier of the headstone or grave marker.
Name
Address
Phone number
Email
Model number or description of the headstone
Epitaph
Have you decided on an epitaph?
Yes___ No___
Choose the details you’d like included in your epitaph.
Name
Date of birth
Date of death
Place of birth
Place of death
A sentence or phrase
A photograph
A symbol
Other
Memorial society
Are you a member of a memorial society?
Yes___ No___
List details for the memorial society.
Name of the memorial society
Contact person
Phone number
Email
Address
Prepaid expenses
Have you prepaid any funeral or burial expenses?
Yes___ No___
Enter the details for each expense that has been prepaid.
Expense
Paid to
Amount paid
Date paid
Contact person
Phone
Email
Address
Comments