Pat Cook Funeral Services

Contact Us

A 24hr help line is available, ring 01522 522881 or you may complete this quick initial application form and we will contact you. 

Completion of the form will also allow us to put into place many of the arrangements to save any unnecessary delay with the funeral service.

Pat Cook Funeral Services Ltd
156 - 158 Burton Road

Tel: 01522 522881


Application Form


*Your name: Your Address:   
*Telephone No:     *Email Address:  
Name of Deceased:    Deceased Address: 
Age:                    Date of Birth:                   Sex:   
Religion:    Place of Death:   
Funeral Type:    Church Service:   
Courtage Form:     Cars Required:   
If there is any other information you think we need to know please write below  

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