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* 1. Are you on the NHS Organ Donor Register?

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* 2. If you are not on the NHS Organ Donor Register, would you be willing to sign up?
(If you are already on the register, skip to question Five)

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* 3. If you are not on the register and you are unwilling to sign up, what are your reasons? Tick all that apply.

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* 4. If you are not on the register but are willing to sign up, what would be the easiest way for you to sign up?

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* 5. If you are on the Organ Donor Register, what were your reasons for signing up? Tick all that apply.

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* 6. If you are on the Organ Donor Register, or are willing to sign up, are you happy for:

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* 7. Do you agree with the idea that everyone should be automatically included on the Organ Donor register with the ability to opt out if they wish?

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* 8. Have you discussed your wishes, whatever they are, with your family?

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* 9. We are hoping to contact those who would be willing to share their views on Organ Donation. If you wish, please leave your details below. These will not be passed on to any third parties.

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