Emotional stress can make decisions very difficult. By planning your funeral in advance you can free your loved ones from such responsibility, allowing them more time to support each other. You may also choose to handle the pre-payment of your funeral through one of our special plans to alleviate any financial burden on your family.


While we welcome a personal meeting to discuss options and services in greater detail, we have provided an on-line pre-arrangement form for your convenience. We understand the sensitivity and privacy of such arrangements, and ensure complete confidentiality with any information you submit. Please feel free to contact us with any questions you may have.

Personal Information
Full Name :
Marital Status : SSN # :
Date of Birth : Birth City / State :
Race : Hispanic / Haitian Origin :
Toledo, Ohio : (year) From : (City / State)
Residence Address :
City : State :
County : Zip :
Phone : E-mail :
Spouse's Name : Spouse's Maiden Name :
Spouse's SSN# : Place of Marriage :
Date of Marriage : Father's Name :
Mother's Name : Mother's Maiden Name :

Work/Education History
Education(0-12) : College 1-5+ :
Occupation :
Business : Company :

Military Record
Branch of Service : Serial Number :
Date Enlisted : Rank At Discharge :
Date Discharged : Discharge On File At :
Copy of Discharge Papers :     Yes     No
Name Of Wars :

Funeral Service Request
Place Of Service :
Church/Other :
Address : Phone :
Place of Visitation :
Religious Denomination :
Place Of Worship :
Lodge / Union :
Person in Charge of Final Arrangements :
Address :
City : State :
County : Zip :
Phone : E-mail :

Special Instructions
Flower Preference :
Music :
Casket Bearers (6) :
(leave blank if funeral
staff to perform) 		1.
2.
3.
4.
5.
6.
Jewelry :
Glasses :
Clothing :
Other :

Disposition Request
I Prefer:
Cemetery :
Address : Phone :
Property Description:
I have made a last will and testament:     Yes     No
Location :

Memberships/Affiliations

Other Instructions

Memorials/Donations To Charity

Please select one of the options below
Send information about pre-arrangement

Contact me to set an appointment

Please keep my information on file


Coyle Funeral Home
1770 S. Reynolds Road | Toledo, Ohio 43614
Phone: (419) 865-1295