Funeral Planning Survey

Full Name *

Email *

Phone (Mobile Number)

Address *

City *

State *

Postal code *

Are you aware that pre-paid funeral plans exist? *

Yes

No

Would you like information or a free consultation about funeral planning, the types of services available, and how you can save money by planning ahead? *

Yes - by phone

Yes - in person

Yes - by Zoom

I consent to receive SMS notifications, alerts & occasional marketing communication from Werner-Harmsen Funeral Home. Message frequency varies. Message & data rates may apply. Text HELP to +1 920-289-8498 for assistance. You can reply STOP to unsubscribe at any time.

Privacy Policy | Terms & Conditions

By checking this box I agree to receive occasional marketing messages from Werner-Harmsen Funeral Home.

Contact us

+1 920-289-8498

Funeral Planning Survey

Werner-Harmsen Funeral Home 2026 | All Rights Reserved

Contact us