Vital Statistics Form 

Please take some time to fill out this ONLINE VITAL STATISTICS form which provides us with the necessary information required for death registration in British Columbia. It also gives us the contact information for the Executor/Executrix or Authorized Representative. Once you click submit, the website sends us an email notification. Please don't hesitate to contact us if you have any questions or concerns.
Arrangement Details

Personal Information

We require the spouse's name for registration no matter the marital status. The other spousal information is only required if the deceased was still married at the time of death.

Disposition Request

Summary Details

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Contact Us

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P.O. Box 367,
118 Fern Road East,
Qualicum Beach, BC V9K1S7  

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Available by Phone 24/7
Office Hours by Appointment

You are welcome to call us any time of the day, any day of the week, for immediate assistance. Or, visit our funeral home in person at your convenience.

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