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SURVEY ON AWARENESS & ATTITUDE ABOUT ORGAN DONATION Dear Member, Kindly take part in this survey on organ donation. If you believe in the cause can we request you to forward the survey or its website address to your friends. This is not only a survey but also our way of educating the public about this sensitive issue that haunts us regularly; more so when a scandal erupts in the country. |
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( Please do not take this survey more than once! ) ( If you have taken the survey before and simply want to reveiw the results, click here) |
| *1. Are you aware that organs can be donated to save a life of another person? | ||||
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Yes No |
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| *2. When Can Organs be donated? | ||||
| During Life After Death Both | ||||
| *3. Which organs can be donated? | ||||
| Eye Skin Heart Lungs Pancreas Kidney Bones Liver All | ||||
| *4. Do you have a relative whose organs have been donated? | ||||
| Yes No | ||||
| *5. Can we sell our organs (like kidney)? | ||||
| Yes No Not Sure | ||||
| *6. Have you heard of brain death? | ||||
| Yes No | ||||
| *7. As the next of kin, would you be willing to donate the organ(s) of a brain dead relative? | ||||
| Yes No | ||||
| *8. Are you aware that a parliamentary law in India recognizes brain death as a form of death so that organs like kidneys, heart, liver and lungs can be donated to needy patients? | ||||
| Yes No | *9. Do you know what is an organ donor card? | |||
| Yes No | ||||
| *10. Are you willing to carry an organ donor card and express your desire about organ donation after your death? | ||||
| Yes No | ||||
| Personal Details | |||||
| *Country : | |||||
| *Email : | Privacy Policy** | ||||
| *Your Age: | (You should be over 15 years to take this survey) | ||||
| *Sex: | Male Female | ||||
| Designation | (If you are working or self employed, Please indicate your designation - this would help us to create in-depth reports on the issue.) | ||||
| *Education Qualification | UG | PG | PhD | Others | |
| *Religion: | Hindu | Muslim | Christian | Others | Not Interested |
| (If you feel too sensitive and do to wish to disclose this information - please mark not interested) | |||||
| Name of Organisation | (If you belong to any school, college, hospital or corporate, please mention it. Invite others in your group and we can send you a customized report.) | ||||
| Any suggestion to improve organ donation in India - | |||||
The names and email addresses entered on this website will not be made available for any other purpose or to any other party. If you wish to receive any promotional material about this organ donation please fill the short membership form on the free download page.
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| The information provided by you is confidential and will not be disclosed except as part of a general research survey to improve organ donation rate in India | |||||
| Chennai | Hyderabad | Mumbai | Pune |