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Funeral Planning Survey
Name
*
First
Last
Email
*
Enter Email
Confirm Email
Phone
*
Address
*
City
State / Province / Region
ZIP / Postal Code
How old are you?
Under 25
24-40
41-65
66 or older
Are you currently:
Employed
Retired
Have you ever been responsible for making funeral arrangements?
*
Yes
No
Which of the following would you choose for yourself?
*
Burial
Cremation
How much might you expect to pay for a funeral?
*
Under $5,000
$4,000 - $6,000
$6,000 - $8,000
Over $8,000
Do you own cemetery property?
*
Yes
No
When your death occurs, who would be responsible for making arrangements?
*
Spouse
Children
Family Member
Other
Do your loved ones know what you would want them to choose?
*
Yes
No
Are you aware that pre-paid funeral plans exist?
*
Yes
No
I/We would like free information about advance planning, the types of services available, and how I/we can save money.
Yes - Funeral Home
Yes - Home Visit
Yes - Zoom Call