9500 Highway 44 E Mt. Washington, KY 40047 (502) 538-7084 (502) 955-7087

Schmid Funeral Home
9500 Highway 44 E
Mt. Washington, KY 40047
(502) 538-7084
(502) 955-7087

Preplanning Request Form

If you would like more information on the benefits of funeral pre-planning, please complete this simple form. Indicate if you would like someone from our funeral home to contact you.

First Name
Last Name
Address
City    State      Zip Code  
Phone
Email
Date of Birth
Interested in Prearranging Funeral For:
  Self  Parent
  Spouse  Other
Type of Service (Choose One):
  Traditional  Memorial
  Graveside  Other
Final Disposition (Choose One):
  Earth Burial  Cremation
  Mausoleum Entombment  Other
I am interested in the following:
  Completing my arrangements, please call me.
  I would like more information on costs and payment options.
  Please register this information in your file.

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