Denver Service Selection

Denver Area Services Selection Form

This form is a services selection form in which you are choosing which services you would like our Funeral Home to perform. By selecting these services you are agreeing that you will have a financial obligation of some amount based on the services selected. You may refer to our website for full descriptions and/or item numbers.

Decedent's Name

$595 A Basic Cremation Package. No Death certificates, Cardboard Temp urn (Must be picked up in Colorado Springs) If 2 staff are required for removal, an additional $75 will be assessed. 5 mile transportation Typically this is for any facility other than a Hospital or Hospice Facility and/ or for people UNDER 200 lbs.

$695 #2 Simply A better Cremation COMPLETE ALL INCLUSIVE (2 Death Certificates, Local delivery by way of usps mailing where you must be present for signature, transportation urn, Online obituary) If 2 staff are required for removal, an additional $75 will be assessed 60 miles of transportation

$895 #3 Economy package (2 Death Certificates, Local delivery or mailing, Personalized Engraving Dark scattering urn, Online obituary) If 2 staff are required for removal, an additional $75 will be assessed

$1295 #4 Super media Package (Package #4 plus Service Folders or Bookmarks Memorial Guest Book, 18”x24” Foam Core Picture, 100 customized Service/Memorial Folders or Bookmarks & 2 Keepsake Sharing Urns.) 4 Day Lead Time If 2 staff are required for removal, an additional $75 will be assessed

$895 #5 Ft logan Placement (direct drop to Ft Logan and 2 Death Certificates) If 2 staff are required for removal, an additional $75 will be assessed

$950 #6 Ft Logan Committal (same as above but includes Booking Of Honors and Committal service) If 2 staff are required for removal, an additional $75 will be assessed

$1225 #7 Ft Logan Patriot package (same as #6 but includes American Urn) If 2 staff are required for removal, an additional $75 will be assessed

8. Urn upgrade Specify Item

Death Certificates: State Charge of $20 and $13 per order

9.a

PENDING CORONER Death Certificates$50 app fee plus $20 per certificate

Total Quantity Needed (2 death certificates included in packages #2, #3, #4 ,#5, #6, #7) :

10. Standard Rush Cremation

$0.00 (7-14 Business Days)

$350.00 Rush (4-6 Business Days)

11.

Are the Decedents weight is over 250lbs, ADDITIONAL charges per our GPL will be assessed

Pacemaker and/or Battery Implanted Device Removal ($100.00)

Additional staff member needed for removal ( non Facility ) house call or over 250 lbs. ($75)

12.

Obituary on our Web Site $0.00 (obituary required in word format and .jpg image required; please mail to Branden@crematecolorado.com)

13. Are we billing Medicaid or DHS? Medicaid has a specific billing procedure that requires admin fees and we are not able to provide discounts to differ from our General Price List (Available upon request) Medicaid will not pay for anything other than labor. Medicaid is NOT a guarantee and you will still be responsible for any funds not covered by Medicaid at full listed price.

Agreement to services selected, please Print Your Name:

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