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Our Family Feedback Form

FAMILY FEEDBACK FORM

In order 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 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-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


 

Immediate Need

If you have immediate need of our services, we're available for you 24 hours a day.

Obituaries & Tributes

It is not always possible to pay respects in person, so we hope that this small token will help.

Pre-Arrangement

A gift to your family, sparing them hard decisions at an emotional time.

Order Flowers

Offer a gift of comfort and beauty to a family suffering from loss.

Daily Grief Support by Email

Grieving doesn't always end with the funeral: subscribe to our free daily grief support email program, designed to help you a little bit every day, by filling out the form below.

Weekly Email Tips to Support a Grieving Friend

It's hard to know what to say when someone experiences loss. Our free weekly newsletter provides insights, quotes and messages on how to help during the first year.

Proudly Serving the Communities of Winchester, Berryville, Frederick County, Clarke County, Gore, Cross Junction, Inwood, Woodstock, Strasburg, Shenandoah County, Hampshire County, Millwood, Stephenson, Whitacre, Middletown, Clearbrook, Front Royal, Stephens City, and Warren County
228 S. Pleasant Valley Road - Winchester, VA 22601 - Phone: 540-662-2523
5485 Mulberry Street - Stephens City, VA 22655 - Phone: 540-869-4072