JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
H.D. Malone Funeral Home Survey
Thank you again for choosing H.D. Malone funeral home. We value your thoughts and feedback on how we can improve the experiences of our customers, so please take a few moments to fill out our survey.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Name
*
Your answer
Email
*
Your answer
How would you rate your overall experience?
*
A
B
C
D
How satisfied were you with the service / ceremony?
Extremely satisfied
Satisfied
Neutral
Unsatisfied
Clear selection
Please rate the following categories
Satisfactory
Average
Poor
Courtesy and professionalism of staff
Knowledge of staff
Appearance and atmosphere of facility
Adequate / sufficient time to plan
Satisfactory
Average
Poor
Courtesy and professionalism of staff
Knowledge of staff
Appearance and atmosphere of facility
Adequate / sufficient time to plan
Clear selection
Please rate our other services available
Satisfactory
Average
Poor
N/A
Pre - planning
Grief counseling
Insursance
Satisfactory
Average
Poor
N/A
Pre - planning
Grief counseling
Insursance
Clear selection
Were there ample amount of options to choose from for personalization ?
Satisfactory
Average
Poor
Clear selection
How satisfied were you with personalization?
Extremely satisfied
Satisfied
Neutral
Unsatisfied
Clear selection
How did you hear about us?
Website
Facebook
Friend
Other
Clear selection
Suggestions for improvement
Your answer
Other Comments
*
Your answer
Can we share your response / testimony on our website and other promotional platforms?
Yes and you can use my name
Yes but I would like to remain anonymous
No
Clear selection
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Mt Sinai C.O.G.I.C..
Report Abuse
Forms
