Questionnaire — Heirloom Echoes

Tell us about yourself

Please fill out this brief survey so we can better understand your needs and begin building a quote for you.
We will be in touch!

Name

First Name

Last Name

Phone

(###)

###

####

Where are you located?

Are you interested in our services for yourself or a loved one?

What services are you interested in?

Legacy Heirloom

End of Life Blessings

Other

If other please elaborate on your unique needs

How long are you or the interviewee comfortable speaking for at a time?

Do you or your loved one need assistance while speaking? such as moral support, translator, nurse, etc.

Have you tried this process before? (written memoirs, video or audio recordings?) if so please briefly describe that process

Are you or the interviewee diagnosed with a terminal illness or nearing death?

Would you describe yourself or the interviewee as an open book? or more of an introvert?

Is there anything else you wish to share? or perhaps you have questions? leave them here