Submit Vital Information

Vitals

DECEDENT'S VITAL INFORMATION

First Name

Middle Name

Last Name

Suffix

Gender

Maiden Name

Date of Birth

Birthplace

Social Security

DECEDENT'S Residence

Street

City

State/Province

ZIP/Postcode

County

Is Residence Inside City Limits?

MARITAL STATUS

Marital Status

Spouse's Full Name

Spouse's Maiden Name

OPTIONAL INFO

Is the decedent a military veteran?

Race

Highest Education

Main Occupation

DECEDENT'S PARENTS

Father's Full Name

Mother's Full Name

Mother's Maiden Name

PERSON MAKING ARRANGEMENTS

Full Name

Relationship to the Person Above

Email Address

Cell Phone

Home Phone

Street

City

State/Province

ZIP/Postcode

IF KNOWN

Date of Death

Place of Death

How Many Death Certificates Do You Need?

Would you like us to create an Online Tribute Page on our website?

CREMATION DECISIONS

Is there a pacemaker present?

After the cremation

URN SELECTION

After the cremation, in what type of container would you like your loved one's cremated remains returned? (choose one)

SERVICE / CEREMONY

Will there be a ceremony before or after the cremation?

FINAL Resting Place

Final Resting Place:

Visit www.prepaidfunerals.texas.gov for information relating to the purchase of pre-need funeral contracts including descriptions of the trust and insurance funding options available under state law.

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Our Location

Integrity Funeral Care
| 3915 Dacoma St Ste E
| Houston, TX 77092
| Tel: 713-344-0764
| Fax: 713-583-7461

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What Do I Do Next?

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Veterans

Veterans Overview
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Contact Us

Visit www.prepaidfunerals.texas.gov for information relating to the purchase of pre-need funeral contracts including descriptions of the trust and insurance funding options available under state law.