Lindquist Mortuaries and Cemeteries

SURVEY

We need your help. We are conducting an on-line survey to determine how members of our community plan for one of the hardest things a family has to face—the death of a loved one. The following eleven brief questions are designed to help us know more about what people want and need at a most difficult time. The results will help us improve our level of service by pinpointing what is most important to you.

1. What is your current age?

Under 35
36-48
49-61
62-74
Over 75

2. Are you currently:

Employed
Retired

3. Have you ever been responsible for making funeral arrangements?

Never
Past 12 Months
Past 3 Years
Past 6 Years
Over 6 Years Ago

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

Burial
Cremation
Unsure

5. How much might you expect to pay for a funeral or memorial?

Under $2,500
$2,500-$5,000
$5,000-$7,500
Over $10,000

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

Yes
No

7. Have you made final plans and arrangements for cemetery property?

Yes
No

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

Yes
No

9. Are you aware that a pre-arranged plan may help you qualify for Medicaid?

Yes
No

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

Yes
No

11. Would it give you peace-of-mind to know you could plan your arrangements in advance and that your family would not have to make arrangements?

Yes
No

CONTACT INFORMATION

Thank you for taking the time to answer these questions. We value your responses. You do NOT need to give us your contact information and can submit your responses anonymously, but if you wish to receive future e-newsletters and/or be contacted by an associate, we will need atleast your name, email address and/or phone number. Thank you.

	Name:
	Address:

	City:
	State:
	Zip Code:
	Phone:
	Email:

YES, please also send me free information about funeral planning, prices and types of services that are available.