Our Family Feedback Form

Home

Our Family Feedback Form

FAMILY FEEDBACK FORM

In order that we at the Scotland Funeral Home are able to serve you better, we know that it is important to accept any criticisms along with praise in order to excel in our cause. We encourage you to provide us with your genuine comments on our ability to serve you in your time of need. Thank you

Sincerely

Scotland Funeral Home Limited

Dave Scotland

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 applies)

Service pre-arranged

Religious affiliation

Recommended by clergy

Recommended by friend

Previously served family

Reputation

Location

Facilities

Prices

Other:

2. How did you hear about our funeral home?

	Newspaper	Yellow Pages
	Recommended by clergy	Getting to know you
	funeral home Employee	Reputation
	Other (please specify):

3.During the arrangement conference, did you find the information provided helpful in making your selections? (please select only one)

Yes

No

Not Sure

4. Was our Staff Courteous?

Yes

No

Not Sure

5. Would you please rate the following IF THEY APPLY! (choose only one response for each item)

	Satisfied	Neutral	Dissatisfied
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 Agree

I Disagree

Not 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)

Yes

No

Not Sure

Additional Comments or Suggestions