Dear Friend,

As a local family-owned business, we believe in reaching out and connecting with our community. We also believe that with your help, we can build a stronger organization - one that will be better equipped to help those in great need.

By sharing your personal story through this quick survey, you will help us understand what is most needed when someone faces the unfortunate task of making final arrangements.

We understand that sharing your personal information is not easy, so please be assured that it will be treated with great care. Your privacy is a great priority to us and it will be guarded accordingly. On behalf of us here at Springfield Funeral Home, and the community as a whole, we want to thank you for your time and help.

Owners, Richard and David Henseleit and Pre-Planning Director, Charlotte Lutzer

guideAS A THANK YOU, WE WOULD LIKE TO OFFER YOU OUR HELPFUL ESTATE PLANNING GUIDE FOR FREE!

 

Options
Respond to the survey AND request the FREE Estate Planning Guide
Respond to the survey ONLY
Request the FREE Estate Planning Guide ONLY

How old are you?
Under 35    35-54    55-65    66-75    76-80    Over 80   

Do you have any children?
Yes    No   IF YES, do they live in the area? Yes    No   

Are you currently...
Employed    Retired   

Do you have a will that has been reviewed and updated in the last five years?
Yes    No   

Have you ever been responsible for making funeral arrangements for someone else?
Yes    No   IF YES, when was it? Within 12 Months    1-2 Years    Over 2 Years   

How much would you expect your funeral to cost?
$2,000-$4,000    $4,000-$6,000    $6,000-$8,000    Over $8,000   

Are you aware that prearranged and prepaid funeral plans exist?
Yes    No   

Is it important to you to provide your family a secure and guaranteed commitment for your funeral plan?
Yes    No   

Do you have a prepaid funeral plan or have funds set aside specifically for funeral arrangements?
Yes    No   

Which of the following would you choose for yourself:
Burial    Cremation   

Are green or natural funeral options important to you?
Yes    No    Not Sure   

Have you made arrangements for your final resting place (cemetery)?
Yes    No   

Do you have up-to-date biographical information and accurate records to help with your funeral planning?
Yes    No    Not Sure   

Are you aware of the notifications and paperwork which must be completed upon your death?
Yes    No    Not Sure   

In the event of your death, who is responsible for making and paying for your funeral arrangements?
Spouse    Children    Other Family Member    Other   

Does this person know your preference including the type of casket, music, flowers and services?
Yes    No   

Prearranging alleviates significant emotional and financial burdens from your family. Which of these is important to you?
Sparing the emotional burden
Avoiding family disagreements
Saving money
Sparing the financial burden
Making sure your wishes are honoured
Peace of mind knowing it's taken care of

Do you think making your final arrangements is your responsibility and as important as keeping your will up to date?
Yes    No   

 


CONFIDENTIAL

All information will be kept strictly confidential.

First Name *

Last Name *

Street Address *

City *

Province *

Postal Code *

Phone *

Email *