End-of-Life Traditions and Cultures * 1. What is your age? Under 18 18 to 24 25 to 34 35 to 44 45 to 54 55 to 64 65 to 74 75 or older OK * 2. What is your nationality? (Ex: 50% Irish, 50% Italian) OK * 3. What is your current religion, if any? Christian/Protestant/Methodist/Lutheran/Baptist Catholic Mormon Greek or Russian Orthodox Jewish Muslim Buddhist Hindu Atheist or agnostic Nothing in particular Other (please specify) OK * 4. What most influenced your choice of religion? Please explain. Family Influence Educational Influence Self Established Other (please explain) OK * 5. In what country do you currently live? United States Other (please specify) OK * 6. Have you ever experienced the loss of a loved one? Yes No OK * 7. What influences your traditions surrounding death? Culture-based traditions Religion-based traditions Both Neither Other (please specify) OK * 8. What is your level of knowledge of hospice care? Very knowledgeable Somewhat knowledgeable Somewhat unknowledgeable Very unknowledgeable OK * 9. Do you have an idea of how you expect to be taken care of when you pass? No Yes (please specify: burial, cremation, etc.) OK * 10. What is your level of comfort talking about death? Extremely comfortable Very comfortable Somewhat comfortable Not so comfortable Not at all comfortable OK DONE