APPENDIX 3

EXAMPLE OF PRO FORMA SUBMISSION QUESTIONS

1. Have you read items 8, 9 and 10 of the information at 'How to make a submission to a Senate Committee Inquiry'?

2. Have you read the Medical Services (Dying with Dignity) Exposure Draft Bill 2014?

3. Do you support the proposal in the Medical Services (Dying with Dignity) Exposure Draft Bill 2014?

4. Why/why not? (please limit response to 100 words)

5. Are you happy for your responses to be published?

6. Your name:

7. Your email address: