Andreason's Cremation & Burial Services

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OUR SIMPLE CREMATION PRICE: $993

24-HOUR HELPLINE: (541) 485-6659

ANDREASON’S CREMATION & BURIAL SERVICE

BUELL FUNERAL CHAPEL

SERVING EUGENE AND SPRINGFIELD, OREGON FOR 73 YEARS

OUR SIMPLE CREMATION PRICE: $993

24-HOUR HELPLINE: (541) 485-6659

ANDREASON’S CREMATION & BURIAL SERVICE

BUELL FUNERAL CHAPEL

SERVING EUGENE AND SPRINGFIELD, OREGON FOR 73 YEARS

Home
Obituaries
Services
Register For Cremation
About Us
Reviews
Urn Gallery
Contact Us

VITAL RECORDS INFORMATION

Free Text

CONTACT INFORMATION FOR PERSON COMPLETING FORM

Contact Person:

Relation:

Cell Phone Number:

Home Phone Number:

Email Address:

Informant Full Address

How did you become aware of Andreason's?:

Relationship to Decedent:

Disposition:

Free Text

DECEASED'S INFORMATION:

Full Legal Name:

Maiden Name (if applicable):

Nickname:

Date of Birth:

Social Security Number*

Sex:

Male

Female

City and State of Birth:

Armed Forces:

Yes

No

Unknown

Branch of Armed Forces:

Air Force

Army

Marines

Navy

Coast Guard

National Guard

Served in Combat:

Yes

No

Unknown

If Served in Combat, Which Countries?:

Complete Street Address:

City:

Zipcode:

Residence County:

Inside City Limits:

Yes

No

Unknown

Deceased's Marital Status:

Married

Widowed

Divorced

Never Married

Legal Separation

Reg. Domestic Partner

Unknown

Spouse's Full Name:

Spouse's Maiden Name (if applicable):

Father's Full Name:

Mother's Full Name:

Mother's Maiden Name:

Highest Level of Education:

Some schooling

High School Grad/GED

Some College

Associates

Bachelors

Masters

PhD

Unknown

Usual Occupation before Retirement:

Type of Industry:

Race (Check all that apply):

White

Filipino

Native

Hawaiian

Black or African American

Japanese

Gumanian or Chamorro

American Indian or Alaskan Native (Specify Tribe)

Korean Samoan

Asian

Indian

Vietnamese

Pacific Islander (Specify)

Chinese

Other Asian (Specify)

Other Race (Specify)

Unknown

Hispanic Origin:

Yes

No

Unknown

Specify Hispanic Origin:

Mexican

Puerto Rican

Cuban

Other (Specify)

If Requested to Specify Race or Tribe:

Would you like a complimentary notice and photo posted to Andreason's obituary page?

Yes

No

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We will get back to you as soon as possible.

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Andreason’s Cremation & Burial Service offers funerals, burials, cremations, and other end of life services to those in need. From our location in Springfield, Oregon, we proudly serve families in the greater Eugene and Springfield areas. This includes Cottage Grove, Veneta, Junction City, Lowell, Elmira, and Coburg, Oregon.

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