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. 2012 Aug 23;12:e39.

Table 1.

Example questionnaire

1. Age
2. Religion (Buddhist/Christian/Catholic/Jewish/Taoist/Muslim/Hindu/Others/None)
3. Gender
4. Educational qualifications (primary/secondary school/tertiary level/university/postgraduate)
5. Have you ever had surgery? (Yes/No)
6. Do you carry an organ donor card? (Yes/No)
7. Have you or a family member ever received an organ transplant? (Yes/No)
 If no; and if you required an organ transplant, for example, kidney that comes with life-long medication with many side effects, would you still accept it? (Yes/No)
  If No; because of (a) cost, (b) I will never want a transplanted organ, (c) I do not want the side effects of medication.
8. Would you consider plastic surgery for:   (a) Cosmetic reasons? (Yes/No)
         (b) If you were disfigured? (Yes/No)
9. Recently a woman in France received a face transplant, are you aware of this event? (Yes/No)
10. Would you consider a face transplant if you were severely disfigured after an accident? (Yes/No/Not sure)
 If no; because of (a) religious beliefs, (b) personal feelings, (c) I feel it is unsafe, (d) cost.
11. Would you consider donating your face afterlife to someone who needs a face transplant? (Yes/No/Not sure)
 If no; because of (a) religious beliefs, (b) personal feelings, (c) I feel It is unsafe.