Funeral Service Contribution Survey

"Our Family Serving Yours"

Thank you for taking the time to contribute to the planning of a meaningful funeral or service for your loved one. Your insights and suggestions will help create a service that reflects the life, values, and spirit of your loved one. All responses will be shared with the next of kin to guide the planning process. Please provide as much detail as you feel comfortable sharing.

Full Loved One's Name

Field label

Your Information

This helps us understand your connection to your loved one and ensures your suggestions are considered appropriately.

Full Name:

Relationship to the Deceased:

Phone Number

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Preferred Type of Service

What type of service feels most appropriate to honor your loved one? Please select one or more options or provide your own suggestion:

Religious Ceremony (please specify denomination or faith, if applicable):

Non-Religious Ceremony

Celebration of Life (a joyful gathering focused on memories and stories)

Memorial Service (a reflective event held after burial or cremation)

Graveside Service

Other (please describe):

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Preferred Type of Service

What type of service feels most appropriate to honor your loved one? Please select one or more options or provide your own suggestion:

Song Titles and Artists:

Preferred Genres (e.g., classical, gospel, jazz, folk, etc.):

Special Notes (e.g., “They loved this song during family gatherings”):

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Preferred Type of Service

What type of service feels most appropriate to honor your loved one? Please select one or more options or provide your own suggestion:

Suggested Readings (e.g., poems, scriptures, literary excerpts):

Personal Stories or Anecdotes (e.g., a memory that reflects their personality):

Cultural or Spiritual Traditions (e.g., specific prayers or rituals):

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Readings, Poems, or Speeches

Consider sharing writings or stories that capture your loved one’s essence or values.

Suggested Readings (e.g., poems, scriptures, literary excerpts):

Personal Stories or Anecdotes (e.g., a memory that reflects their personality):

Cultural or Spiritual Traditions (e.g., specific prayers or rituals):

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Readings, Poems, or Speeches

Consider sharing writings or stories that capture your loved one’s essence or values.

Display Ideas (e.g., photo boards, memory tables, videos, or slideshows):

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Mementos or Keepsakes (e.g., items like a favorite book, hobby-related objects, or personal belongings):

Special Activities (e.g., releasing balloons, planting a tree, or a shared moment of reflection):

Dress Code or Theme (e.g., wearing their favorite color, casual attire, or a theme tied to their interests):

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Participation in the Service

Would you like to take an active role in the service?

Yes, I’d like to participate. Please describe how (e.g., delivering a eulogy, reading a poem, sharing a memory, performing music, or assisting with a ritual):

Yes, I’d like to participate.

No, I prefer to contribute through this survey.

Please describe how you would like to participate (e.g., delivering a eulogy, reading a poem, sharing a memory, performing music, or assisting with a ritual):

Support Needs (if participating, e.g., “I’d need help preparing my speech”):

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Participation in the Service

Would you like to take an active role in the service?

Preferred Location (e.g., funeral home, place of worship, outdoor setting, or a meaningful place like their favorite park):

Atmosphere (e.g., formal, casual, intimate, or festive):

Additional Considerations (e.g., accessibility needs, seating arrangements, or virtual attendance options):

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Readings, Poems, or Speeches

Consider sharing writings or stories that capture your loved one’s essence or values.

Charitable Contributions (e.g., donations to a cause they cared about):

Shared Activities (e.g., signing a memory book, bringing a memento, or participating in a group tribute):

Other Ideas:

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Additional Comments or Suggestions

Is there anything else you’d like to share to help make the service special? This could include stories, traditions, or ideas not covered above.

New Field:

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Submission Instructions

Please submit this survey as soon as possible.

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Your responses will be thoughtfully reviewed by the next of kin, who is responsible for the arrangements, and our planning team to create a service that honors your loved one’s memory. If you have any questions, please contact us at (208) 522-7424.

Thank you for your contribution during this time.