Helping Families and Friends Honor Their Loved One for over 100 years.

212 South Locust Glenwood, IA 51534

Peterson Mortuary, Inc.

712-527-4805

Please call us anytime

Send Sympathy Flowers

For a floral tribute that blooms with breathtaking beauty.

Home
Obituaries
Services
- Veterans
Plan Ahead
Grief and Healing
- Support Groups
- Additional Support Resources
About Us
- Our Location
- Information Request
Flowers and Memorials

Funeral Planning Survey

It would help us greatly if you would answer the questions on this survey. Your answers will help determine where our future time and resources need to be focused. All answers will remain confidential.

1 Survey

2 Contact Info

1. What is your age group?
- Under 25
- 26-40
- 41-65
- 66 or older
2. Have you ever made funeral arrangements for a loved one?
- Yes
- No
3. If yes, did you choose the funeral home because…
- Reputation in the community
- Our family has used this funeral home before
- Newspaper/Phone book
- Comparative Pricing
4. Do you own cemetery property?
- Yes
- No
5. Where do you read the obituary information?
- Newspaper
- Funeral Home Website
- Newspaper Online
6. Would information on donating your organs be of value to you?
- Yes
- No
7. If you have lost a loved one, would a follow-up visit (after the service) about extended programs available be of value to you?
- Yes
- No
8. Is Advanced Funeral Planning something that:
- You’ve heard about
- You have considered
- You would like to know more about
- Other family members have done
9. Are your loved ones aware of your funeral preferences?
- Yes
- No
10. If you had to decide today, which would you select:
- Anatomical Donation
- Memorial Service
- Funeral service with a casket
- Graveside Only
11. To offer you the most in personalization, please indicate which of the following you would be interested in for yourself or a family member: (Check items of interest)
- Balloon Release
- Dove Release
- Evening Services
- Patriotic Theme
- Multi-Media Presentation (Slides, Video, ect)
- Service in a unique location
- Celebration of Life Service (Music, Speakers)
12. I would be interested in receiving more information on preplanning
- Yes, Please Call
- Yes, Please Mail
- Yes, Please Email
- Would like to meet at Funeral Home
- No
13. Advance Funeral Planning is available for everyone regardless of age or situation. Your wishes and preferences can be recorded and payments can be arranged to guarantee current prices. Pre-payments can be made in full or can be extended for as long as needed to accommodate you and your family. There’s no cost or obligation for inquiring and we encourage everyone to learn the facts and benefits of preplanning. Would you like to learn more about how this can work for you?
- Yes
- No - Not at this time

Name
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
Email
Comments
This field is for validation purposes and should be left unchanged.

Δ

Peterson Mortuary

Our professional and caring staff is dedicated to working with your family to provide assistance in selecting high quality and affordable funeral services during a time of sorrow.

Testimonals

I wanted to take a moment and thank you again for the very nice service you performed for John's memorial. I had several people come up to me to say "what a wonderful funeral". It was a nice tribute to him."

- Alexander Davis

View All Testimonials

Contact Information

212 S. Locust Street
Glenwood, IA 51534
(712) 527-4805
info@petersonmortuaryinc.com
Map & Directions

© 2024 Peterson Mortuary, Inc. All Rights Reserved Terms of Use and Privacy Policy