What is your age?

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* 1. What is your age?

What is your nationality? (Ex: 50% Irish, 50% Italian)

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* 2. What is your nationality? (Ex: 50% Irish, 50% Italian)

What is your current religion, if any?

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* 3. What is your current religion, if any?

What most influenced your choice of religion? Please explain.

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* 4. What most influenced your choice of religion? Please explain.

In what country do you currently live?

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* 5. In what country do you currently live?

Have you ever experienced the loss of a loved one?

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* 6. Have you ever experienced the loss of a loved one?

What influences your traditions surrounding death?

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* 7. What influences your traditions surrounding death?

What is your level of knowledge of hospice care?

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* 8. What is your level of knowledge of hospice care?

Do you have an idea of how you expect to be taken care of when you pass?

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* 9. Do you have an idea of how you expect to be taken care of when you pass?

What is your level of comfort talking about death?

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* 10. What is your level of comfort talking about death?

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