Thank You for Choosing Johnson Funeral Home

Please take a quick survey to let us know about your experience and how we can improve our services.

Selection of Funeral Homes

What factors were important in the selection of the funeral home to serve you? (please select all that apply)

If other, please specify:

How likely would you be to recommend this funeral home to others? (please select one)

Overall, how would you rate this funeral home? (please select one)

How likely are you to use this funeral home again? (please select one)

Funeral Arrangements

How would you rate the staff of the funeral home?
Timely Response:
Attention to Detail:
Communication Skills:
Professional Conduct & Appearance:
Ability to Address Your Needs:

How would you rate the handling of making the arrangements?
Excellent Courtesy & Compassion of Staff:
Understanding of Your Service Needs & Wishes:
Ability to Fully Answer Your Questions:
Fully Explained Available Service Options:
Provided a Variety Options for Merchandise:
Clearly Explained Service Costs:
Gave Enough Time to Make Choices:
Professionalism & Expertise of Staff:

Were you satisfied with the options that were available? YesNo

Funeral Home Facility

How would you rate the funeral home facilities?
Interior Furnishings & Appearance:
Availability of Parking:
Interior & Exterior Lighting:
Occupancy Capacity for Guests:
Convenience of Location:
Handicap Accessibility:
Overall Cleanliness:

Professional Services & Merchandise

How would you rate the professional services that were offered? (please select one)

Was the cost of the professional services provided… (please select one)

How would you rate the merchandise that was offered?
Casket & Vault Selection & Options:
Cremation Urn Selection & Options:
Type of Tribute & Memorial Options:
Personalized Options (e.g., jewelry, candles):

Were you informed about veteran’s or social security benefits that you may be entitled to? YesNo

Actual Service

Were you satisfied with the appearance of your loved one? YesNoN/A

If you had special requests for the service, were you accommodated? YesNo

Would you like to be contacted by us to pre-arrange and/or pre-pay for your funeral or that of a loved one? YesNo

Additional Comments

Looking back, is there anything you would change about the service?

Do you have any additional comments that you would like to share? We would like to use your comment on our website.

Please provide your contact information:
First & Last Name:


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Thank you for your time and business.

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