Please note that by completing and submitting or faxing the On Line At Need Form to Lupinski Funeral Home, Inc. that this is NOT considered notification that a death has occurred. Please call the funeral home at 203-865-4205 to speak with a funeral director.
Thanks for taking the time to fill out our Immediate Need Form. By completing the following information at your own convenience, you should find it easier to provide correct information and have some time to think about the type of services you desire.
The information provided on this form will help Lupinski Funeral Home, Inc. complete the death certificate and other required documents. In addition, this information will assist the funeral director to better understand your initial wishes. Relaying required statistical information can be time consuming. Our desire is to help expedite the final arrangement conference at the funeral home and make the process a little more comfortable.
Please complete (as much as possible) the information on the form and select Submit Information at the end to send the information to us. You may also print out the form and bring it with you to the arrangement conference or fax.
If you'd prefer, a printer-friendly version of this form is also available for you to download and fill out manually. CLICK HERE for further instructions and the download link, if interested.
If you have any questions whatsoever, please contact Lupinski Funeral Home, Inc. at: 203-865-4205
Important Note: Viewing of the body is a choice of the family. In most cases, embalming is required or recommended for public viewing/visitation, mausoleum entombment, or transfer of remains via common carrier (i.e. shipment by air or rail). When possible, the funeral home needs authorization from the next of kin for embalming.Except in certain cases, embalming is not required by law. Embalming may be necessary, however, if you select certain funeral arrangements, such as a funeral with viewing. If you do not want embalming, you usually have the right to choose an arrangement, which does not require you to pay for it, such as a direct cremation, immediate burial and/or one-time ID viewing for family only. If you elect NOT to order embalming, State law requires refrigeration of an unembalmed body that is held for over 24 hours from the time of death.
You can download the printer-friendly version of the Immediate Need Form to your local computer from the link below. Once downloaded, open the PDF *, and enter your information on the form, then print it out on your printer. You may then fax it to us at the fax number below, or bring it with you when you visit.
» CLICK HERE to download the form - choose to, 'Save to Disk,' in the dialog box that appears (download times will vary depending upon connection.)
Completed forms may be faxed to the number below::
Please call with any questions: 203-865-4205