Funeral Intake Form

Submission Entry

Contact Info

First Name

Last Name

Phone

Leave this field blank:

Website

Relationship to Deceased

Deceased Info

Deceased Name

Deceased Age

Date of Passing

Anything else you'd like us to know about your loved one?

Officiating Pastor

Pastor Leading the Service

Name of your pastor or pastor you're requesting

If you're providing your own pastor, please provide their phone number & email

Service Details

The Campuses of The Well Community Church are a functioning space. The capacity, wall, floor space, and stage are subject to change due to church gatherings and/or events.
Your event is subject to the facility's availability which is why we encourage you to request a couple dates
The facility is not available on the following days: Sunday through Wednesday, Easter Weekend, Memorial Day, Independence Day, Labor Day, Thanksgiving week, week before Christmas, week of Christmas, week of New Year's, and the week before and week of Summerpalooza.

Requested Services

Celebration of Life Service Reception Other

Requested Date #1

Requested Date #2

Requested Date #3

Number of Attendees

Will Food be Served

Once this form is submitted, our Care Team will review it to check your date's availability. Someone will reach out to you in the next couple of days to confirm your date and gather more information. Please reach out to care@thewellcommunity.org if you have any additional questions.

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