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Our Family Feedback Form

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• Dufferin Home
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• Feedback Form

In order to serve you better, we know that it is important to accept any criticisms along with praise to excel in our business. 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 the 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