Insane Patient Form

[Renasance [Admin]]

It's A Mad, Mad World

[Insert Picture Here, IMG code unless stretching]

We Like Your Face We'd Really Like To Sell You[/u][/size]
Full Name;
Nickname(s)
Gender;
Age;
Face Claim;

I Don't Like The Drugs, But The Drugs Like Me
Diagnosed Mental Disorder(s)
Age Of Diagnose(s)
Suicide Attempt(s)/Murder Attempt(s) (y/n) and if yes, then dates
Do You Hear Voices? (y/n) and if yes, then for how long

And How Does That Make You Feel?[/u][/size]
Personality (2 & 1/2 paragraphs minimum)
Appearance (2 & 1/2 paragraphs minimum)
History (3 paragraphs minimum)

It's All Relative[/u][/size]
Siblings (also note if any are at Willowcreek)
Significant Other (put N/A if none)
Children (Put N/A if none)[/color]

[color=maroon][size=4][i]It's A Mad, Mad World[/i][/size]

[center][Insert Picture Here, IMG code unless stretching][/center]

[size=3][b][u]We Like Your Face We'd Really Like To Sell You[/b][/u][/size]
[b]Full Name;[/b]
[b]Nickname(s)[/b]
[b]Gender;[/b]
[b]Age;[/b]
[b]Face Claim;[/b]

[size=3][b][u]I Don't Like The Drugs, But The Drugs Like Me[/u][/b][/size]
[b]Diagnosed Mental Disorder(s)[/b]
[b]Age Of Diagnose(s)[/b]
[b]Suicide Attempt(s)/Murder Attempt(s)[/b] (y/n) and if yes, then dates
[b]Do You Hear Voices?[/b] (y/n) and if yes, then for how long

[size=3][b][u]And How Does That Make You Feel?[/b][/u][/size]
[b]Personality[/b] (2 & 1/2 paragraphs minimum)
[b]Appearance[/b] (2 & 1/2 paragraphs minimum)
[b]History[/b] (3 paragraphs minimum)

[size=3][b][u]It's All Relative[/b][/u][/size]
[b]Siblings[/b] (also note if any are at Willowcreek)
[b]Significant Other[/b] (put N/A if none)
[b]Children[/b] (Put N/A if none)[/color]