FAMILY FEEDBACK FORM

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:    ZIP Code:  
Phone:  
Funeral Home-related Feedback

Name of the Funeral Director who assisted you:

1.  Why did you choose Steeley Funeral Home?  (Choose all that apply.)
Service pre-arranged Religious affiliation
Recommended by clergy Recommended by a friend
Previously served your family Reputation
Location Facilities
Prices Other (specify): 

2.  How did you hear about Steeley Funeral Home?  (Please select only one.)
Newspaper Phone Book / Yellow Pages
Recommended by clergy Website
Steeley Funeral Home employee Reputation
Other (specify):  

3.  During the arrangement conference, did you find the information that was provided helpful in making your selections?  (If your answer is "no," please explain why in the Comments box below.)
Yes No Not Sure

4.  Was our staff courteous?  (If your answer is "no," please explain why in the Comments box below.)
Yes No Not Sure

5.  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 the Deceased
Visitation
Arrangement coordination
Appearance of the Funeral Home (indoors & outdoors)
Staff attitude


6.  Please respond to the following statement:  "The prices charged by Steeley Funeral Home were reasonable."  (If you disagree with this statement, please explain why in the Comments box below.)
I Agree I Disagree Not Sure

7.  Based on your experience, would you recommend Steeley Funeral Home to others?  (If your answer is "no," please explain why in the Comments box below.)
Yes No Not Sure
Additional Comments or Suggestions


 

 

 

87 North Main Street | SELLERSVILLE, PA 18960-2327 | Phone: 215-257-4622 | Fax: 215-257-1560 | Email: steeleyfuneralhome@comcast.net