Intake Form 

|
|

We understand that this is a difficult time for you. Thank you for taking the time to provide this important information so that we can better serve you and your family.

About the Deceased:
First, Middle, Last
Please click to change date






(if not applicable, please put "NA")

Length of time living here?

Please click box to change date
Please click box to change date




Send Us a Message

Contact Us

Call Us
334-222-8440

location_on Address
Andalusia Chapel
206 Stanley Ave
Andalusia,AL, 36420

Clio Chapel            1411 Blue Springs St.   Clio, Alabama, 36017

Cope-Keahey          705 Perryman St. Evergreen, Alabama, 36401


Email
keaheyfuneralhome1@gmail.com

access_time Hours
On Call 24/7

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.

local_florist


© 2026 Keahey Funeral Home. All Rights Reserved. Funeral Home website by CFS & TA | Terms of Use | Privacy Policy | Accessibility