Immediate Need | Hampton-Hutton Funeral Home

First, let us express our deepest sympathy for your loss. Please know that we are here for your family during this difficult time.

Your first step should be to contact us as soon as possible, day or night, at (606) 546-5168. We will guide you through the immediate next steps, arrange for your loved one to be brought into our care, and schedule a time to meet with you and your family to begin making funeral arrangements.

If you would like, you may also complete the form below before or after speaking with us. The information you provide will help us begin preparing for your arrangements and save time during your meeting.

Immediate Need Form

Free Text

Personal Information of the Deceased

Last Name*

Middle Name

First Name*

Date of Birth*

Date of Death*

Social Security Number*

Free Text

Preparation Information

Has a Doctor / Coroner Been Notified?

Yes

Free Text

Physician Information

Name of Doctor Signing Death Certificate

Email Address

Business Telephone

Street

City

State/Province

Zip/Postcode

Free Text

Personal Information of Person Legally Responsible for Disposition

Last Name*

Middle Name

First Name*

Relationship to Deceased*

Street*

City*

State/Province*

Zip/postcode

Primary Phone Number*

Secondary Phone Number

Best Time to Reach Via Phone*

Do You Have a Prearrangement on File with Us?

If Yes, Under What Name?

When you need help most

Immediate Need Form