For Immediate Need Call: 843-718-0144

24hr On-Call Director: 843-872-1267

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Home
About Us
Obituaries
Services
Plan Ahead
Grief Support
Resources

Get in Touch

For Immediate Need Call: 843-718-0144

24hr On-Call Director: 843-872-1267

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WELCOME TO

Dickerson Mortuary

Where Service is Key

Immediate Need

If A Death Has Just Occurred

Immediate Need Form

Free Text

PERSONAL INFORMATION OF THE DECEASED

First Name*

Middle Name*

Last Name*

Date of Birth*

Date of Death*

Time of Death

Social Security Number*

Email Address*

Business Telephone*

Street Address*

City*

State*

Zip Code*

Free Text

PERSONAL INFORMATION OF PERSON LEGALLY RESPONSIBLE FOR DISPOSITION

First Name*

Middle Name*

Last Name*

Relationship to Deceased*

Street Address*

City*

State*

Zip Code*

Primary Phone Number*

Secondary Phone Number

Best Time to Reach Via Phone*

Do you have arrangements on file with us?

If Yes, Under What Name?

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