End of Life

LEGACY PLANNING FORM

In late 2014, Interim Minister, Reverend Doak Mansfield, and a panel of experts conducted a Legacy Planning workshop open to all UUCT members.

The workshop covered many end-of-life issues including:

  • Required health directives
  • Financial and legal considerations
  • Legacy planning
  • Choices for final arrangements

It is important that all UUCT members be aware of the form to help individuals designate what end-of-life decisions they have made, how they want them carried out, and their choices regarding a memorial service. The form appears below.

The document is entitled Personal Planning Information for Minister’s Registry. Church members’ completed files will be kept in the minister’s private office. When the time comes, this form will prove helpful to people carrying out a UUCT member’s final wishes about a celebration-of-life service and any final disposition of remains and resting place directives.

To fill out your form, simply print this page. Then, after completing the form, give it to the minister or the UUCT office assistant for safe keeping. It is a good idea to give a copy to your designated representative and to keep a copy for yourself.

Any questions about the form or UUCT’s end-of-life ministry should be discussed directly with our current minister. E-mail:  RevP@uutampa.org


Unitarian Universalist Church of Tampa

PERSONAL PLANNING INFORMATION FOR MINISTER’S REGISTRY

(PLEASE PRINT)

Member Name:  _____________________________________________________________________

Home Address:

___________________________________________________________________________________

___________________________________________________________________________________

___________________________________________________________________________________

Phone # (          ) ________________________   E-mail ________________________________________

Primary Contact:  ______________________________________________________________________

Relationship:        __________________________________   Phone # (           ) _____________________

Obituary Author: __________________________________   Phone # (           ) _____________________

The following are my choices for final arrangements on my behalf:

     Traditional Burial ______ Funeral Home in Charge::_____________________________________________

     ___________________________________________________________________________________

     Contact Information: (          ) __________________________________________________________

     Designated Burial Site _______________________________________________________________

     Graveside Service:      Yes ____ No____

     Pallbearers:

______________________________________________Contact #_________________

______________________________________________Contact #_________________

______________________________________________Contact #_________________

______________________________________________Contact #_________________

______________________________________________Contact #_________________

______________________________________________Contact #_________________

OR

     Cremation_______ Designated Organization___________________________________________________

       _____________________________________________________________________________

     Contact Information:  (          ) ___________________________________________________

     Designated Recipient of Cremains: _______________________________________________

     Relationship:  ____________________________ Phone # (         ) _______________________

OR

     Donation of Remains to Science: _____  Designated Organization:

___________________________________________________________________________________

___________________________________________________________________________________

___________________________________________________________________________________

     Contact Information:  (          ) ________________________________________________________

The following are my choices regarding a Memorial Service:

Location:  Church _____   Funeral Home _____ Other _____________________________________________

To Officiate:  __________________________________________________________________________

Participating Organization/s:   Military____________ Fraternal____________ Other_______________

Music and other elements I would like included:

   Hymns:

___________________________________________________________________________________

___________________________________________________________________________________

___________________________________________________________________________________

   Other Music – Solo, Choir, Instrumental, Recordings:

___________________________________________________________________________________

___________________________________________________________________________________

___________________________________________________________________________________

   Readings:

___________________________________________________________________________________

___________________________________________________________________________________

___________________________________________________________________________________

   Poems:

___________________________________________________________________________________

___________________________________________________________________________________

___________________________________________________________________________________

   Special Presentations, Performances, or Exhibits

___________________________________________________________________________________

___________________________________________________________________________________

___________________________________________________________________________________

Memorial Donations should be directed to the following: ___________________________________________________________________________________

___________________________________________________________________________________

___________________________________________________________________________________

Following the service I prefer for family, friends, and guests:

A reception with refreshments and food to be served:

     At the church _____

     At my home _____

     Alternate location __________________________________________________________________

These are my wishes and directives written this _____ day of _______________, 20____.

_______________________________________________________
Member Signature

_______________________________________________________/_____________________
Witness Signature / Date

_______________________________________________________/_____________________
Witness Signature / Date


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