Feedback Form

In order to serve you better, we know that it is important to accept any criticisms along with praise to excel in our business. We encourage you to provide us with your genuine comments on how well we served you in your time of need.

 
Personal Information
Name:  
Address: 
City:Postal Code:  
Phone: 
Funeral home related feedback

Name of the Funeral Director who assisted you:

1. Why did you choose our funeral home? (Choose all that apply)
Service pre-arrangedReligious affiliation
Recommended by clergyRecommended by friend
Previously served familyReputation
LocationFacilities
PricesOther: 
2. How did you hear about our funeral home?
NewspaperYellow Pages
Recommended by clergyGetting to know you
funeral home EmployeeReputation
Other (please specify):  
3.During the arrangement conference, did you find the information provided helpful in making your selections? (please select only one)
YesNoNot Sure

4. Was our staff courteous?
YesNoNot Sure
5. Would you please rate the following, if the apply. (choose only one response for each item)
SatisfiedNeutralDissatisfied
Initial contact with our firm
Arrangement Conference
Merchandise Selection
Appearance of Deceased
Visitation
Arrangement Co-Ordination
Appearance of facilities
Staff Attitude
6. Please respond to the following statement,"The prices charged by our funeral home were reasonable." (Choose the one that applies)
I AgreeI DisagreeNot Sure
7. Based on your experience, would you recommend our funeral home to others? (If the answer is no, please explain below in the provided comments box)
YesNoNot Sure
Additional Comments or Suggestions


 

 

390 North 2nd Street | Woodburn, OR 97071 | Phone: (503) 981-7771 | Fax: (503) 982-7810 | Email: robertcornwell4@aol.com, myfuneraldirector@yahoo.com