Form

It is of the utmost importance to our funeral home to understand how you felt about your experience with us. We ask for your candid remarks and we can use your input to better service our families.

Email*

Name of Deceased

Relationship status

First name

Last name

Funeral Home Name

Street address

Phone number

City

State/Region

Professionalism of Staff

Dissatisfied

Below Expectations

Met Expectations

Satisfied

Extreamly Satisfied

Appearance of our Funeral Home

Dissatisfied

Below Expectations

Met Expectations

Satisfied

Extreamly Satisfied

Attention to the details of your request

Dissatisfied

Below Expectations

Met Expectations

Satisfied

Extreamly Satisfied

Economics of our pricing structure

Dissatisfied

Below Expectations

Met Expectations

Satisfied

Extreamly Satisfied

What influenced you to use our funeral home?

Would you use our funeral home again when the need arises?

Yes

Would you recommend us to friends and family?

Yes

Do you think pre- arranging makes sense or does it sound silly?

Makes sense

Sounds Silly

As a gift we want you to have your copy of The Family Emergency Record Guide

A lot of families found this resource (7 Stages of Grief) a great benefit in dealing with some of the emotions after the loss of a loved one.
We strongly suggest some level of support because there are somethings you are not supposed to do right away!

We will provide a Family Emergency Record Guide for all of the family and friends who supported you during your loss.

Friend and Family contact information