obituary questionnaire

Preface

Let's begin by setting a tone for this remembrance.

Would you like to select a mood or tone for this obituary?

Choose any tone that resonates with you. You can say something like inspirational, celebratory, heartfelt, reflective, or factual.

What are 2-3 of the most important personality traits or qualities that most people will remember about your loved one?

We'll use these words as an overarching guide to capture the essence of your loved one's life and legacy. You can use words like kind, humorous, caring, generous, intelligent, adventurous, loyal or whatever else you feel fits best.

Personal Details About the Deceased

Let's start with some basic information.

First Name

Middle Name

Last Name

Affectionate or Popular Nickname

What name would you like to use for the deceased throughout this obituary?

Details of Passing

Date of Passing

Place of Passing

Age at Passing

Cause of Death (Optional)

Nature of Passing (Optional)

Sudden, unexpected

Brief illness

Long term illness

Peaceful passing

Please feel free to share any additional details you'd like to add about the passing of

Did they pass surrounded by friends and family? Did they pass in a special location?

Special Instructions

If you'd like to address the passing of your loved one in a very specific manner, please use this space.

Birth Details

Date of Birth

Place of Birth

Hospital

Would you like to share any unique or interesting facts, stories, or memories about the birth?

You can add things like birth weight, time of day, where the mother went into labor, or news events of the day.

Parents

Let's get some information about the parents and/ or guardians of . To avoid repeating the same information later, we may ask you whether some family members are living or have already passed.

Mother's Full Name

Mother's Hometown

Mother's Occupation

Mother: Living or passed?

Still with us

Deceased

Father's Full Name

Father's Hometown

Father's Occupation

Father: Living or passed?

Still with us

Deceased

Additional Parent(s) / Guardian(s)

Full Name	Hometown	Occupation

Additional Parent: Living or passed?

Still with us

Deceased

Siblings

List all siblings, in order, biological or otherwise, who were dearly loved and cherished by the deceased.

Siblings

Full Name	Older or Younger	Living or deceased?

Childhood

List all siblings, biological or otherwise, who were dearly loved and cherished by the deceased.

What location(s) did spend most of their childhood?

Location(s)

As a child, what did want to be when they grew up?

What activities did enjoy as a child?

Did carry any cherished childhood activities into adulthood?

Would you like to share any powerful or impactful stories, successes or challenges related to their childhood?

Would you like to mention anything about special sibling relationships or their childhood relationships in general?

Education I: High School

Let's highlight some notable educational accomplishments and milestones for

High School Graduated From

City, State

Year Graduated

Scholarships, Awards, Recognition

Sports, Clubs, Extracurricular Activities

Would you like to list any important mentors or friendships of from high school?

Did they meet their future spouse or lifelong friends in high school?

Would you like to share any additional high school memories, traditions or hangouts?

You can include things like first jobs, first cars, artistic or recreational pursuits, major life events.

Education II: Continuing Education

Let's highlight some notable educational accomplishments and milestones.

College, University and Trade Schools

School	City. State	Area of Study	Year Graduated / Attended

College Degrees, Honors, Awards

Sports / Extracurricular Activities

Would you like to list any lifelong friendships or mentorships started in college?

Would you like to share any additional college clubs, Greek organizations, accomplishments, excursions, or memories that were important to ?

Spouse or Life Partner

Most Recent Spouse / Life Partner

Residence

Occupation

Living or deceased?

How and where did they meet?

When and where was their wedding or union ceremony? Feel free to provide details about the wedding.

Other Funny, Romantic, or Impactful Relationship History / Details (Optional)

Who proposed, and where? What activities did they enjoy together? Did they have nicknames for each other? What were their favorite travel destinations?

Children

Please share the names of anyone held dear as a child, whether they were biological, adopted, foster, step, or simply loved as family.

While we recognize this may be a difficult question, knowing whether each person listed is currently living or deceased is helpful for us to accurately document your loved one's family, and ensures you won't need to repeat this information later in the form.

Children

Full Name	Spouse of Child (optional)	Residence	Living or Deceased?

Special Notes: Children

Please feel free to add any personal or descriptive information about the children of . Children and their spouses will also be listed in separate "Survived By" portion.

Close Friends

Please feel free to honor the dear friends who played an important role in the life of .

Close Friends

Full Name	Location

Would you like to share how met their closest friends?

Any special activities, trips, accomplishments and memories with friends or friend groups?

Did they golf together? Take annual trips? Did they have a specific hangout or special location to meet? Did they share certain hobbies?

Career Milestones

Reflect upon your loved one's various careers, entrepreneurial spirit, and innovative pursuits.

Employers

Employer	Title	Number of Years Employed

Owned Businesses

Company Name	Industry / Description	Number of Years Owned

Professional Associations, Organizations, Unions

Certifications and Licenses

Major Work Projects, Passions, Accomplishments, and Recognition

Did your loved one have a career milestone they were particularly proud of?

Would you like to mention any influential work or career mentors?

Charities, Organizations and Volunteer Work

Some description about this section

Charity or Organization

Organization	Role	Years

How did become involved with each organization and why was it important to them?

Major Charity Related Accomplishments, Awards, Recognition, Impact, Travels

Religious Affiliation

Church / Place of Worship

How did their spiritual beliefs influence their life and relationships?

Military

Highlight medals, awards, and recognition received for their service.

Military Branch

Years

Rank

Unit or Division

Where Served

War or Conflicts Served

Medals and Decorations

Specialized military skills or duties:

Hobbies and Passions

List creative outlets, hobbies, and activities that ignited their passion and enthusiasm for life.

Hobbies, Interests and Passions

Activity	How did they become involved in this hobby/passion?

Cherished Collectibles or Memorabilia

Hobby Related Groups, Clubs and Organizations

Notable awards, memories and achievements related to passions and hobbies

Favorites

Let's remember some personal favorites of :

Favorite Movie

Favorite Sports Team

Special Mentor or Idol

Favorite Food or Restaurant

Favorite Music or Band(s)

Favorite Place or Travel Destination

Favorite Book / Author

Favorite Celebrity

Other Favorites

Personal Kryptonite

What particular weakness did everyone know about? Chocolate? Puppies? Donuts? Woodworking? Wine?

Places Lived

Share some of the different places called home.

Locations of Residence

City, State or Country	Years

What was their favorite residence and why?

What was your loved one's favorite travel destination and why?

Personality Questions I

Let's talk about what people loved most about .

Did have any signature quirks, habits or mannerisms that everybody knew about?

Example: They always wore a certain item of clothing, had a contagious laugh, or aggressively stood up for friends.

If had an opportunity for a "perfect day", how do you think they would have chosen to spend that day?

How did make people feel when they were around him/her?

Personality Questions II

Let's talk about what people loved most about .

Did have a unique or humorous obsession with any cultural staple like a TV show, book series, celebrity, or musical act?

Example: "She never missed an episode of her favorite soap opera and would often discuss the plot twists with friends and family." "He had (band) playing all the time in the car."

How did have a profound impact on your life or the lives of others? Did provide a moment or experience that significantly shaped who you are today?

Example: Did they come save you in a time of need? Were you comfortable sharing everything with them, knowing it would forever remain confidential?

Would you like to share any pivotal moments, events or life experiences that significantly shaped your loved one's life or personality?

Did your loved one find sobriety? Did religion or an overseas trip change their life? Did a particular illness, accident or passage of a loved one change their outlook on life?

Personality Questions III

Let's talk about what people loved most about .

How do you think would like to be remembered?

What would say was his/her proudest achievement in life?

What specific qualities made such a remarkable parent, grandparent, sibling or friend?

(Example: Their patience, their ability to listen, their sense of humor, always put others before themselves)

Your Final Words and Thoughts

Let's finish off with any information you'd like to include that didn't fit earlier in the form.

Include anything else you'd like to say about your loved one here:

Survived By

Grandparents

Grandparents Name	Residence

Number of Surviving Grandchildren

Number of Surviving Great Grandchildren

Grandchildren by Name (Optional)

Grandchild Name	Grandchild Residence

Other Survived By

Other Family/ Friends/ Pets	Residence

Predeceased By:

List any loved ones that may have already passed.

Grandparent(s)

Grandparent Name

Other Predeceased By:

Name and Relationship

Memorial Services and Reception Information

Provide some information about memorial services. Information about the reception is on the next page.

Type of Service

Common types of services include: Funeral, Memorial Service, Celebration of Life, Visitation, Wake, etc.

Location of Service

Date of Service

Time of Service

Special Instructions or Information About Services

You can include information about parking, hosts, pallbearers

Reception Information

Provide some information about the reception.

Location of Reception

Date of Reception

You can also write "Immediately After Services" or "Immediately Afterwards"

Time of Reception

You can also write "Immediately After Services" or "Immediately Afterwards"

Special Instructions or Information About Reception

You can include information about parking, food, directions

Memorial Contributions to Charity

Charity Contact (Website, Phone or Address)