For the sake of medical records, we need you to fill out this form and keep a record of those who have paid a visit to Dr. Leorio's Clinic. In other words, a clique! For those patients who have a website of their own, this is a good way to let me link to ya. So go ahead and fill this up.
Click here to see the list of members. There are currently two (2) who have documented their visit to the clinic.
Here's an example:
Name: Kikiam [email] [home]
Seems pretty easy, huh? After submitting, wait for a reply from me that says whether you get in or not, then put this code on your site:
Wait for at most a month [gomen] for me to put your name here. After a month, you can go back and check if your name is already on the list. If not, you can drop me a mail at email@example.com. It may be that I've become too busy with my school work or my pc crashed again, so I hope you'll be considerate. ^_^