Funeral Home Health Assessment
Please complete the following form
Business Name
Your Name
Your Email
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Business Overview
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Website
Year Founded
Number of Employees
Please list the companies you engage with for the following technologies
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Networking & Community Outreach
My Funeral Home regularly engages in Community Outreach efforts with networking groups, boards, event sponsorships, etc.
Not Involved
1
2
3
4
Very Involved
5
1 is Not Involved , 5 is Very Involved
My Funeral Home has cultivated relationships with local Clergy and Community Leaders
No Relationships
1
2
3
4
Very Strong Relationships
5
1 is No Relationships, 5 is Very Strong Relationships
My Funeral Home has established connections with other Professionals to drive Pre-Need Engagement
No connections
1
2
3
4
Very Strong Connections
5
1 is No connections, 5 is Very Strong Connections
My Funeral Home regularly participates in educational events about Pre-Planning
Yes
No
My Funeral Home has an interest in expanding our community engagement
No Interest
1
2
3
4
Very Interested
5
1 is No Interest, 5 is Very Interested
Do you have an annual budget for Marketing and/or Events?
Yes
No
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