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| Do you have a Will? |
Yes No
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| Has it been updated lately? |
Yes No
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| Have you ever made funeral arrangements before? |
Yes No
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If 'Yes': |
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Within the Past Year 1 to 3 Years Over 3 Years
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| How much do you think funerals cost? |
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Have you been informed that Pre-Arranged and Funded funeral plans exist? |
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Yes No
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| Do you have a pre-paid funeral plan? |
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Yes No
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| If "No", have you ever considered a prepaid funeral plan? |
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Yes No
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| Have you purchased Life Insurance to help pay for your funeral arrangements? |
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Yes No
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| If "Yes", does the beneficiary understand the policy and the reason for having this policy? |
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Yes No
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| When choosing your arrangements, would you choose? |
Burial Cremation Mausoleum Entombment Not Sure
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| Have you purchased cemetery property? |
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Yes No
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| In the event of your death, who will be responsible for making your funeral arrangements? |
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Spouse Children Other family member Other
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| Who will be responsible for making the payment of your arrangements? |
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Spouse Children Other family member Other
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| Does the person making the arrangements know of all your preferences, including casket, flowers and services? |
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Yes No
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| Would making your own arrangements give you peace of mind knowing that you have planned and paid for your own funeral arrangements? |
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Yes No
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| Do you feel that making your own funeral arrangements are as important as keeping your life insurance and will up to date? |
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Yes No
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| If you have any further comments or questions that we help us then please use the box that we have provided below: |
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