Below is a list of all field names available for user created pre-filled forms. Please follow this link to view your funeral home specific fields.
DECEDENT’S BASIC VITAL INFORMATION
| Field Name on Form or Document | Description | Example Output |
|---|---|---|
| Contract_No | At Need Contract Number | |
| DeceasedFullName | Full name of Decedent (First, Middle, Last, Suffix) | Justin X. Ample IV |
| Last | Last Name | Ample |
| First | First Name | Justin |
| Middle | Middle Name | X. |
| Suffix | Suffix | IV |
| Maiden | Maiden Name | |
| Sex | Sex | Male |
| Sex_FirstLetter | Sex | M |
| Age | Age | |
| SSN | Social Security Number or Social Insurance Number | |
| Street_of_Residence | Street of Residence | 123 Main Street |
| City_of_Residence | City of Residence | Chicago |
| State_of_Residence | State/Province of Residence | Illinois |
| Zipcode_of_Residence | Zip or Postal Code of Residence | 60290 |
| County_of_Residence | County of Residence | Cook County |
| Race | Race | |
| Birthplace | Place of Birth (City, State or Province) | Fort Monroe, Virginia |
| Marital Status | Marital Status | Married |
| Spouse | Spouse’s Name | Mary Ample |
| Spouses_Maiden | Maiden Name of Spouse | Mary Jones |
| Father | Father’s Name | John Ample |
| Mother | Mother’s Name (as entered on vitals screen) | Susan Ample |
| Mothers_Name | Mothers Name and Maiden in parenthesis | Susan Ample (Johnson) |
| Survivors | Survivors | |
| Ministers_On_One_Line | Minister(s) names) | |
| Place_of_Death | Place/Facility of Death | University of Chicago Medical Center |
| Address_of_Death | Street address of Death Location | 5841 S. Maryland Ave |
| City_of_Death | City of Death Location | Chicago |
| State_of_Death | State or Province of Death Location | IllOntarioinois |
| Zipcode_ of_Death | Zip or Postal Code of Place of Death | 60637 |
| County_of_Death | County of Death Location | Cook’s County |
| Country_of_Death | Country of Death | United States |
| Funeral_Director_Name | Funeral Director | |
| Funeral_Director_License_Number | Funeral Director License Number | |
| Embalmer_Name | Embalmer | |
| Embalmer_License_Number | Embalmer License Number | |
| Physician | Physician | |
| Obituary | Obituary Text |
DECEDENT’S SERVICE AND DISPOSITION INFORMATION
| Field Name on Form or Document | Description | Example Output |
|---|---|---|
| Place_of_Service | Service Location | FrontRunner Funeral Home |
| PlaceOfServiceStreet | Place of Service Street Address | 6A Clarence Street |
| PlaceOfServiceCity | Place of Service City | Kingston |
| PlaceOfServiceState | Place of Service State/Province | Ontario |
| PlaceOfServiceZipcode | Place of Service Zip or Postal Code | K7L 5H8 |
| PlaceOfServiceAddressFull | Place of Service Street, city, State/Prov, Zip/Postal | 6A Clarence Street, Kingston, Ontario, K7L 5H8 |
| VisitationPlace | Location of Visitation 1 | FrontRunner Funeral Home |
| VisitationStreet | Street Address of Visitation 1 Location | 6A Clarence Street |
| VisitationCity | City of Visitation 1 Location | Kingston |
| VisitationState | State/Province of Visitation 1 Location | Ontario |
| VisitationZipcode | Zip/Postal Code of Visitation 1 Location | K7L 5H8 |
| Visitation_Checkbox_Yes | Visitation – yes (for checkbox) | |
| Visitation_Checkbox_No | Visitation – no (for checkbox) | |
| Disposition | Type of Disposition | |
| Disposition_Place | Cemetery or Crematory Name | |
| Disposition_Address | Street, City, State/Prov, Zip/Postal Code | |
| CrematoryName | Crematory Name | |
| CrematoryAddress | Street Address of Crematory | |
| CrematoryCity | City of Crematory | |
| CrematoryState | State/Province of Crematory | |
| CrematoryCounty | County of Crematory | |
| CrematoryZipcode | Zip/Postal Code | |
| CemeteryName | Cemetery Name | |
| CemeteryAddress | Street Address of Cemetery | |
| CemeteryCity | City of Cemetery | |
| CemeteryState | State/Province of Cemetery | |
| CemeteryCounty | County of Cemetery | |
| CemeteryZipcode | Zip/Postal Code of Cemetery | |
| GraveLocation | Grave Location | |
| Hospital_Status | Hospital Status | |
| NonHospitalStatus | Non Hospital Status |
DECEDENT’S LEGAL CONTACT INDIVIDUALS
| Field Name on Form or Document | Description | Example Output |
|---|---|---|
| InformantFullName | First Middle Last, Suffix of Information | Justin X. Ample IV |
| Informant_First_Name | Informant First Name | Justin |
| Informant_Middle_Name | Informant Middle Name | X. |
| Informant_Last_Name | Informant Last Name | Ample |
| Informant_Suffix | Informant Suffix | IV |
| Informant_Title | Informant Title | Mr. |
| Informant_Telephone | Informant Telephone | |
| Informant_Relationship | Informant Relationship to Decedent | |
| Informant_St | Street Address of Informant | |
| Informant_City | City of Informant | |
| Informant_State | State/Province of Informant | |
| Informant_Zip_Code | Zip/Postal Code of Informant | |
| Informant_Country | Country of Informant | |
| Informant_EmailAddr | Email Address of Informant | |
| BuyerFullName | First Middle Last, Suffix of Buyer | Justin X. Ample IV |
| Buyer_First_Name | Buyer First Name | Justin |
| Buyer_Middle_Name | Buyer Middle Name | X. |
| Buyer_Last_Name | Buyer Last Name | Ample |
| Buyer_Suffix | Buyer Suffix | IV |
| Buyer_Title | Buyer Title | Mr. |
| Buyer_Phone | Buyer Telephone | |
| Buyer_Relationship | Buyer Relationship to Decedent | |
| Buyer_Street | Street Address of Buyer | |
| Buyer_City | City of Buyer | |
| Buyer_State | State/Province of Buyer | |
| Buyer_Zipcode | Zip/Postal Code of Buyer | |
| Buyer_Country | Country of Buyer | |
| BuyerEmail | Buyer Email Address | |
| NOK_Name | Full Name of Designated Primary Next of Kin | |
| NOK_Street | Street Address of NOK | |
| NOK_City | City of NOK | |
| NOK_State | State/Province of NOK | |
| NOK_Zipcode | Zip/Postal Code of NOK | |
| NOK_Phone | Phone Number for NOK | |
| NOK_Relationship | NOK Relationship to Deceased |
DATES AND TIMES
| Field Name on Form or Document | Description | Example Output |
|---|---|---|
| Date_of_Birth_YMD | Date of Birth – Year/Month/Day | 1927/2/22 |
| Date_of_Birth_MDY | Date of Birth – Month/Day/Year | 2/22/1927 |
| Date_of_Birth_DMY | Date of Birth – Day/Month/Year | 22/2/1927 |
| Date_of_Birth_Text | Date of Birth Text – Month Day, Year | February 22, 1927 |
| Date_of_Death_YMD | Date of Death – Year/Month/Day | 2013/4/15 |
| Date_of_Death_MDY | Date of Death – Month/Day/Year | 4/15/2013 |
| Date_of_Death_DMY | Date of Death – Day/Month/Year | 15/4/2013 |
| Date_of_Death_Text | Date of Death Text – Month Day, Year | April 15, 2013 |
| Date_of_Service_YMD | Date of Service – Year/Month/Day | 2013/4/17 |
| Date_of_Service_MDY | Date of Service – Month/Day/Year | 4/17/2013 |
| Date_of_Service_DMY | Date of Service – Day/Month/Year | 17/4/2013 |
| Date_of_Service_Text | Date of Service Text – Month Day, Year | April 17, 2013 |
| Date_of_Interment_YMD | Date of Interment – Year/Month/Day | 2013/4/17 |
| Date_of_Interment_MDY | Date of Interment – Month/Day/Year | 4/17/2013 |
| Date_of_Interment_DMY | Date of Interment – Day/Month/Year | 17/4/2013 |
| Date_of_Interment_Text | Date of Interment Text – Month Day, Year | April 17, 2013 |
| Date_of_Visitation_Text | Date of Visitation 1 Text – Month Day, Year | April 17, 2013 |
| VisitationTime_1_Range | Time of Visitation #1 | 2:00 pm – 3:00 pm |
| Time_of_Service_24HR | Service Time 24 Hour Format | 15:30 |
| Time_of_Service_12HR | Service Time 12 Hour Format | 3:30 pm |
| Time_of_Death_24HR | Time of Death 24 Hour Format | 03:15 |
| Time_of_Death_12HR | Time of Death 12 Hour Format | 3:15 am |
| Time_of_Interment_24HR | Time of Interment 24 Hour Format | 16:00 |
| Time_of_Interment_12HR | Time of INterment 12 Hour Format | 4:00 pm |
| Time_of_Visitation_12HR | Time of Visitation #1 – 12 Hour Format | 4:00 pm |
| TheDate_Numeric | The current date when the form is run | 2/19/2014 |
| The Date_MonthDayYearText | The current date when the form is run | |
| The Date_MonthText | The current date when the form is run | |
| TheTime | The current time when the form is run | 1:45 pm |
FUNERAL HOME INFORMATION
| Field Name on Form or Document | Description | Example Output |
|---|---|---|
| Funeral_Home_Name | Funeral Home Name | |
| Funeral_Home_License_Number | Establishment License Number | |
| Funeral_Home_Street | Street Address of Funeral Home | |
| Funeral_Home_City | City of Funeral Home | |
| Funeral_Home_State | State/Province of Funeral Home | |
| Funeral_Home_Zipcode | Zip or Postal Code of Funeral Home | |
| Funeral_Home_Phone | Phone Number of Funeral Home | |
| Funeral_Home_Fax | Fax Number of Funeral Home | |
| Funeral_Home_Name_And_Address_Full | FH Name and Full Address |
Need more help with this?
Don’t hesitate to contact us here.