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My Personal Impressions Survey Response

General Information:

Your Name:

Street

City

State/Province

ZIP/Postcode

Telephone

Name of Deceased:

Relationship to the Deceased:

Was this your first experience with Humphrey Funeral Service?

YesNo

What factors influenced you to choose Humphrey Funeral Service (Check all that apply):

Media Advertising Radio TV Print Internet

Social Media Facebook Twitter YouTube

Internet Search Google Yahoo Bing etc

Previous Services to Your Family or Friends

You Know A Member of Our Staff

Comparison with Other Funeral Homes

Our Reputation in the Community

Our Chapel Facilities

Chapel Service Live Streaming Recording

Our Emphasis on Honoring Veterans

You Had A Burial Association Policy with Us

Your Had A Pre Need Arrangement with Us

Recommended By Someone:

If you were recommended by someone, please share with us their name so we can thank them:

Your Time of Need:

When taking your loved one into our care, how did we help you and your family?

When making your arrangements with us, how did we help you the most?

When you met with our staff, in what ways did we make you feel comfortable?

In what ways did we make you feel uncomfortable, if any?

Your Funeral Services:

What did you like most about our funeral home and chapel facilities?

What did you like most about the Memory Folder we designed?

What did you like least about the Memory Folder?

What did you like most about the Video Life Tribute we produced?

What did you like least about the Video Life Tribute?

How did the Celebration of Life service help you?

What was the best part of the Celebration of Life service for you?

If your loved one was a veteran, what services did we provide?

Arranged military honors Gun Salute Taps

Presentation of the American Flag

Ordered Grave Marker

Arranged Interment in a National Cemetery

Encasement of Ribbons Medals

Flag Draped Casket

Of these services, which ones were most helpful & meaningful to you?

Your Cremation Services:

What "Dignity Cremation" services were provided for your loved one?

Direct Dignity Cremation no visitationno service

Cremation with a Memorial Service

Public Visitation followed by Cremation

Complete visitation and Memorial service followed by Cremation

Burial of Cremains in A Cemetery

Special Urn Selection and Optional Products

If your cremation services included a visitation or memorial service, please respond to applicable questions under "Your Funeral Services" above.

How do you feel about our unique approach to "Dignity Cremation?"

At your private family confirmation viewing prior to cremation, what was most helpful to you?

Were you pleased with the way your loved one's cremains were returned and the wooden urn in which they were placed?

YesNo

If not, how would you have been better satisfied?

General Impressions:

Rate the effectiveness of our chapel service live-stream (1=Not Effective; 5=Highly Effective):

12345Not Applicable

Rate the effectiveness of our chapel DVD recording:

12345Not Applicable

Rate the effectiveness of our graveside set-up & amenities:

12345Not Applicable

Rate the effectiveness of our website obituary & online guestbook:

12345Not Applicable

Rate the effectiveness of our large easel portrait:

12345Not Applicable

Rate the effectiveness of our balloon release:

12345Not Applicable

Rate the effectiveness of our Irish Petal Blessing:

12345Not Applicable

How did the Funeral Director assigned to your family help you the most?

What will you tell your friends about Humphrey Funeral Service?

What is the single-most important part of your experience with Humphrey Funeral Service?

If you could change any one thing about your experience with us, what would it be?

What could we do in better serving families?

Please write a statement to summarize your experience with us that we might choose to share with others:

May we use your name when quoting?

YesNo

Would you do us one more quick favor? If you have a Google email account, please give us a Google Business rating by clicking this link: g.page/HumphreyFuneral/review

Follow-Up Options:

Would you like to discuss a pre-need arrangement with us as some future point?

YesNo

Best Telephone Number to Reach You:

Best Day and Time to Reach You:

What arrangements are you most interested in?

Traditional BurialDignity Cremation CenterCenter Valley Memorial Gardens

When would you like for us to contact you?

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A year of daily grief support

Our support in your time of need does not end after the funeral services. Enter your email below to receive a grief support message from us each day for a year. You can unsubscribe at any time.