Phaneuf Funeral Homes and Crematorium Survey
1.

What is your current age?

Under 35
36 - 48
49 - 61
62 - 74
75 or older
2.

Have you ever been responsible for making funeral or cremation arrangements?

Never
Past 12 Months
Past 18 Months
Past 24 Months
Over 24 Months Ago
3.

If you have given any thought to the subject, which of the following would you choose for yourself?


Burial
Cremation
Unsure
4.

Do you maintain up-to-date biographical information and accurate family records to assist you or a loved one with funeral planning if the need arises?

Yes
No
5.

Have you made final plans and arrangements for the type of funeral or cremation service you desire?

Yes
No
6.

Are your loved ones aware of what you would prefer for your own arrangements?

Yes
No
7.

Would it give you peace-of-mind to know you could plan your funeral or cremation in advance and that your family would not have to make these difficult arrangements?

Yes
No
8.

Finally, would you like to receive a Free Pre-planning guide along with prices?

Yes - If so complete the information below
No
9.

Please provide the following information to receive a Free planning guide, information and prices. This is important information every family should have, and there is no cost or obligation.


By entering my personal information, I consent to receive email communications from the survey author's organization based on the information collected.

First Name:
Last Name:
Home Phone:
Email Address:
emailaddress@xyz.com
Address 1:
Address 2:
City:
State/Province
(US/Canada):
Postal Code: