Funeral Director Survey Question Title * 1. What is your title in the funeral industry? Funeral director Mortician Other Question Title * 2. Do you offer services for those who experience stillbirth? (Stillbirth being considered pregnancy loss at 20 weeks or greater) Yes No Comment Question Title * 3. Do you offer service for those experiencing miscarriage? (Pregnancy loss at less than 20 weeks) Yes No Comment Question Title * 4. Do you offer caskets for your families experiencing pregnancy loss thorough stillbirth? We do not offer caskets for stillbirth We offer one or two choices in caskets for stillbirth We three or four choices in caskets for stillbirth We offer several choices in caskets including wood, plastic, and cloth covered wood I wish we knew of more choices in caskets to offer clients Comment Question Title * 5. Do you offer caskets for your families experiencing pregnancy loss though miscarriage? We do not offer caskets for miscarriage We offer one or two choices in caskets for miscarriage We offer three or four choices in caskets for miscarriage We offer several choices in caskets including wood, plastic, and cloth covered wood I wish we knew of more choices in caskets to offer clients Question Title * 6. Do you offer several choices in urns for your families experiencing pregnancy loss? We do not offer urns for babies We only offer one or two choices of baby urns We only offer three or four choices of baby urns We offer many choices of baby urns I wish we knew of more choices in urns to offer clients Question Title * 7. When dealing with a family experiencing pregnancy loss, do you offer the family the choice to hold the baby prior to burial or cremation? Yes No Comment Question Title * 8. On a scale of 1 - 10 (1 being easy and 10 being very difficult), how difficult is it for you as a funeral service professional in dealing with the death of a small baby? Question Title * 9. How are your rates determined for pregnancy loss services? We charge the same as our adult funeral services We have special rates for babies We do not charge for baby funerals We only charge for our costs for baby funerals Comment Question Title * 10. Do you feel like you can only offer the least expensive casket? No we offer a wide variety of caskets at many prices We only offer a low cost casket We offer a low cost casket because we offer it for free We assume new parents cannot afford a casket over $250 Comment Question Title * 11. How do you take the baby from the hospital to the funeral home? (Select any that apply) We transport the baby in a special cloth bag We transport the baby in a blanket We transport the baby in a small body bag We transport the baby in a cooler We transport the baby in a special box Other Comment Question Title * 12. Have you ever had people try to look at the baby when you were transporting the baby out of the hospital? If you select yes, please select any of the other options listed. If you select no, you may continue the survey. Yes No We use something inconspicuous to transport the baby We do not use a public exit when transporting the baby People want to look because they think the baby is alive It makes me very uncomfortable when people want to look It makes me very uncomfortable to transport the baby Other Comment Question Title * 13. When a baby is too small to embalm, how do you preserve the baby’s remains? We submerge the baby in a chemical solution We do not preserve the baby We place a Vaseline type product on the baby’s skin so it does not dry out We submerge the baby in saline water solution Other Comment Question Title * 14. What companies have you used for your baby caskets and urns? Cherokee Child Caskets Wilbert Heaven’s Gain Caskets and Urns McCord In the Light Urns and Caskets Others Question Title * 15. Do you provide any of the following for parents? (Check all that apply) Rocking Chair Bathing equipment Dressing Table Foot and Hand prints Lock of Hair Caps Nursery songs/music Dressing Gowns Other Comment Question Title * 16. Do you allow or assist parents with any of the following? Home visit with baby Outdoor walk with baby Baptism Young sibling visits Other Comment Question Title * 17. Do you provide families the use of a portable Cuddle Cot or Cooling Bassinette? Yes No I am not familiar witht these products. Comment Question Title * 18. Do you help parents locate support resources and burial/cremation assistance? Yes No Comment Question Title * 19. Do you offer any services for small infant funerals that would be different than your adult funerals? (If no, leave blank) Question Title * 20. Do you have any suggestions of what has worked well for you when dealing with families experiencing pregnancy loss? (If no, leave blank) Question Title * 21. Do you have any suggestions of things to avoid when dealing with families experiencing pregnancy loss? (If no, leave blank) Question Title * 22. Do you have trouble finding small burial vessels for babies born who are smaller than 12 inches? No, I have burial vessels/caskets for my families who lose a baby smaller than 12 inches. Yes, I have trouble locating burial vessels/caskets for families who lose a baby smaller than 12 inches. I do not serve families who have lost a baby that small. No, but I would like to know where I could find affordable burial vessels that small. (We can send you information on a few companies, who offer small burial vessels/caskets, if you enter you e-mail address below) e-mail address for information Done