We are conducting a short survey to determine how residents in our community plan for one of the hardest things a family has to face - the death of a loved one.

Would you be willing to answer a few short questions?

Please click the arrow to continue.

What is your current age?

Under 35
36 to 48
49 to 61
62 to 74
75 or over

Have you ever been responsible for making funeral arrangements?

Never
In the past 12 months
In the past 18 months
In the past 24 months
Over 24 months ago

How much would you expect to pay for a funeral?

Under $2,500
$2,500 to $5,000
$5,000 to $7,500
$7,500 to $10,000
over $10,000

Do you keep current biographical information and precise family records to aid family members with funeral preperation if necessary?

Yes
No

Have you made arrangements and final plans for cemetary property?

Yes
No

Which of the following would you choose for yourself?

Cremation
Burial
Unsure

If you have decided on the type of funeral service or cremation you desire, have you made final plans and arrangements?

Yes
No

Have you made your loved ones aware of your arrangement preferences?

Yes
No

Would knowing that you could pre-plan your funeral so that your family would not have to make arrangements give you peace of mind?

Yes
No

Are you aware that a prearranged funeral plan may help you qualify for Medicaid?

Yes
No

Are you aware that Hindman Funeral Homes owns and operates the only crematory in Cambria County and all other funeral homes outsource cremation?

Yes
No

Are you aware that Hindman Funeral Homes is the only area Veterans & Family Memorial Care Provider and Veterans and their spouse are offered a 10% discount?

Yes
No

Please fill out this short form so that we can provide you with additional information.
First Name:
Last Name:
Address:
City:
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