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1. What is your title?

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2. What faith/denomination would you consider yourself?

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3. Do you feel you have had enough training on how to minister to families experiencing stillbirth, infant loss, or miscarriage?

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4. Do you wish you had more training on serving families who are experiencing miscarriage or stillbirth?

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5. Do you offer funeral services for families experiencing a pregnancy loss? (Check any that apply)

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6. Do you offer burial services for families experiencing a pregnancy loss? (Check any that apply)

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7. Do you know your states laws pertaining to burial of a baby? (Check any that apply)

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8. Does your church/parish/congregation/organization have a ministry that provides support for families experiencing pregnancy loss? (Check any that apply)

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9. Are you aware of the guidelines for determining if a pregnancy loss is considered to be a miscarriage or a stillbirth?
* Miscarriage - Unintentional pregnancy loss prior to 20 weeks gestation.
* Stillbirth - Unintentional pregnancy loss from 20 weeks gestation until completed delivery

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10. Do you feel parents who experience pregnancy loss are in need of support? (Select any that apply)

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11. What is your faith's belief pertaining to unbaptized/unchristened infants that die?

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12. Does your faith allow the baby's mother to attend funeral and burial services for the baby?

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13. Does your faith allow cremation?

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14. Does your faith require burial of cremated remains?

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15. If you have a facility code please enter the code below.

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