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

Would you like information or a free consultation about funeral planning, the types of services available, and how you can save money by planning ahead?

Yes - by phone
Yes - by email
Yes - in person
Yes - by Skype

Cemetery & Funeral Services

888-704-0404

Funeral Planning Survey