Request a Service

COVID-19 UPDATE (5/31/20): The ability to perform in person tributes will be assessed on a case by case basis, as regulations may differ from county to county. Please understand that our members will be wearing masks for any in person tribute. Thank you.

Those requesting the service need to be either a family member, clergy, funeral director, or other individual directly involved with the funeral planning of the fallen nurse.
All information from here to the bottom of the form pertains to the nurse that we are being asked to honor. Please provide the appropriate answer (if known) with the honoree's details. Thank you.