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Funeral Preplanning
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Step
1
of 12
Name
*
First
Last
Email
*
Phone Number
Secondary Phone Number
family your can
Next
What is your current age?
*
Over 65
61 - 65
56 - 60
46 - 55
35 - 45
Under 35
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Next
How important is it to you to ensure your family knows and honors your wishes?
*
Very important
Not important
Haven't thought about it
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Next
Do you want to leave your family with a sense of peace, knowing everything is already planned?
*
Yes I want my family at peace
No not a concern
I'm unsure
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Next
How important is it to you to ensure your family can come together in peace, without disagreements or confusion, because your wishes are clearly planned?
*
Very this concerns me
Not important
I'm unsure
Previous
Next
Do you want to ensure your family can focus on grieving and healing instead of making difficult decisions?
*
Yes absolutely
No that's not a priority
I'm unsure but would like to learn more
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Next
Are you aware that planning today could save your family THOUSANDS of dollars in the future?
*
Yes, I know
No, I don't know
I'd like to know how
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Next
Do you believe that pre-arranging your final wishes is one of the greatest gifts you can give to your family?
*
Yes, it's a gift of love
No, I don't see it that way
I'm unsure
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Next
Does the idea of arranging everything from the comfort of your home appeal to you?
*
Yes that sounds convenient
No I'd prefer in person
I'm unsure
Previous
Next
Where do you live?
Previous
Next
Are you interested in any other services as well?
Financial Planning
Legal
Realty
Medicare
Long Term Care
Taxes
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Next
Is there any other information you'd like for your MAPP Certified Specialist to know?
Previous
Submit
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