| 1.
What is your current age? |
35-44
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45-54
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55-64
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65-74
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75
or over
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| 2.
Are you currently: |
Employed
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Retired
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| 3.
Have you ever been responsible for making funeral arrangements? |
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Never
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Past
12 months
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Past
12-24 months
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Over
24 months ago
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| 4.
If you have given any thought to the subject, which
of the following would you choose for yourself? |
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Burial
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Cremation
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| 5.
How important to you personally is the location of the: |
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Funeral
Home?
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Cemetery?
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| 6.
How much might you expect to pay for a funeral? |
| |
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Under
$2,000
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$4,000-$6,000
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$8,000-$10,000
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$2,000-$4,000
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$6,000-$8,000
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Over
$10,000
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| 7.
Do you maintain up-to-date biographical information
and accurate family records to assist you or a loved
one with funeral planning? |
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Yes
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No
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| 8.
Have you made final plans and arrangements for: |
| |
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| Cemetery
property? |
Yes
|
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No
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|
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|
|
| The
type of funeral service you desire? |
Yes
|
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No
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| 9.
Are you aware that a prearranged funeral plan may help
you qualify for Medicaid? |
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Yes
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No
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| 10.
Are your loved ones and family members aware of what
you would prefer for your own arrangements? |
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Yes
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No
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| 11.
In the event of your death, who would make funeral arrangements? |
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Spouse
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Child(ren)
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Family
Member
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Other
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| 12.
Would it give you peace of mind to know you could do
the planning in advance and that your family would not
have to make arrangements? |
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Yes
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No
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| 13.
Would you like free information about funeral planning
and the types of services, which are available? |
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Yes
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No
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At
Dee Funeral Home and Cremation Service, we have pre-planned
options to fit almost any need and financial situation.
Please contact us to receive a free guide to pre-planning.
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