Clique

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.

Rules:

  1. This clique is only applicable to those with their own URL's.
  2. You can make up any disease you want as long as it's about Leorio.
  3. Absolutely no flaming of Leorio-san!
  4. Don't leave any field blank.
  5. NO TWO PEOPLE CAN HAVE THE SAME DISEASE, 'K? Unless the two of you have already talked it out.
  6. Put the code on your site before signing up. Its not that I check submissions right away, but this is quite an essential rule in cliques and fanlisitngs.
  7. If you're really reading this: In the question 'Did you read the rules, answer 'Dancin' Yodel Night' instead of 'Tobira'.

Name:

Date today:

Email:

Site URL:

Disease you were cured of:

Disease description and treatment:

Question
Tobira
Dancin' Yodel Night

   

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]
Date of treatment: 07.09.2k2
Disease: Yodling Syndrome: A case wherein the patient experiences hallucinations and severe pain in the head that causes the patient to yodle endlessly until the pain subsides. Can only be cured by ice cream and listening to Dr. Leorio yodle himself.

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 kikiam_sama@hotmail.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. ^_^

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