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amavia™ Provider Directory
By submitting this form, you consent to being contacted by amavia regarding potential future participation. Submitting this form does not guarantee placement or immediate involvement.
Business Name
*
Country (Canada or United States)
*
Location / Service Radius (list city/town)
*
Service Type (Faith or Cultural Preference, Funeral & Memorial, Ceremony & Faith Based, Support & Wellness, Floral & Keepsake Services, Venues & Coordination, Professional Services, Other)
*
Faith or Cultural Preference
*
Faith or Cultural Preference
Christian
Catholic
Protestant
Jewish
Muslim/ Islamic
Hindu
Buddhist
Indigenous / First Nations / Métis / Inuit
Non-denominational / Humanistic
Other
Funeral & Memorial
*
Funeral & Memorial
Funeral Home
Cremation Provider
Burial Service / Cemetery
Memorial Planning
Green / Eco Burial
Children
Infants
Pets
N/A
Ceremony & Faith-Based Services
*
Ceremony & Faith-Based Services
Officiant / Celebrant
Religious Leader / Chaplain
Spiritual / Multi-Faith Guidance
Memorial Planning
Cultural or Traditional Ceremony
N/A
Support & Wellness
*
Support & Wellness
Grief Counsellor / Therapist
Bereavement Coach
Support Group Facilitator
End-of-Life Doula
Meditation / Mindfulness Support
N/A
Floral & Keepsake Services
*
Floral & Keepsake Services
Florist / Floral Designer
Memorial Keepsakes / Urns / Jewelry
Tribute Artwork / Portraits
N/A
Venues & Coordination
*
Venues & Coordination
Event Venue / Reception Hall
Catering / Hospitality
Musician / Choir / Audio Services
Photography / Videography
N/A
Professional Services
*
Professional Services
Legal / Estate Planning
Financial / Insurance Support
Printing / Design / Obituary Services
N/A
Other (please specify - list items that are not listed in our intake form)
Description (describe your services)
Packages / Prices (list any promotions/bulk offers that you may be offering)
*
Budget Range
*
Availability Link (i.e. Calendly)
*
Contact email or phone
*
Add-Ons (If you offer any additional services or packages families can choose from, such as floral upgrades, ceremony personalization, or memory keepsakes, please list them here.)
Upload Logo / Photos (max 6 files)
*
Click to choose a file or drag here
Accepts image files
Size limit: 10 MB
Status (for amavia™ personnel to fill out)
Would you like families to contact you directly through amavia™?
*
Would you like families to contact you directly through amavia™?
A
Yes, I welcome direct contact.
B
No, please have amavia™ reach out on my behalf.
C
Unsure / need more information.
Consent
*
Consent
I understand that Amavia may offer a 90-day complimentary listing period when provider participation opens. After this period, continued participation may be available at $20/month, with the option to opt out at any time by contacting support@amavia.life
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