This page is a collection of the bureaucratic nightmare forms that I have created for use by Command staff and other positions. Think of it as a spiritual successor to Adhara's way better page on the subject. Now updated to tgui paper!
Instructions for Filing
The basic format of each form includes the following.
- The header of each form contains an index number; a 4-digit number identifying the chronological order of the filing of a piece of paperwork which is entered in by either the applicant or a relevant authority if the form is a request. This number starts from 0001 and increments by 1.
- The numbering scheme assigns a number to a piece of paperwork in chronological order, regardless of its type. For example, a C-1 form followed by an A-2 form would be numbered as 0001 and 0002 respectively.
- Some forms contain a "case number" that, though not chronological, allows Security to keep track of what form belongs to what case. It also starts from 0001 and increments by 1.
- The form's main body includes fields that must be filled out using a pen. Some special fields require the use of the [sign] tag.
- Some documents include an end section where an authority, usually a member of Command, approves/rejects the form if it is an application or request. In this case, there are fields for approval stamps, reasons for denial (if applicable), a field for stamping the shift time, and a field for the authority's signature.
General Command Forms
To do: AI Law upload request, AI Law reset request, AI core creation request w/ consent form for the brain donor
Head of Personnel Forms
A-Series: Employment and Station Access
A-1: Access Request
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# NanoTrasen Access Request Form A-1
_This form is to be used in the case that personnel request additional access to certain departments and areas be granted to them._
**Index No. [____]** _(Official use only)_
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**For Applicant's Input**
_Please fill out the underlined areas with a pen._
**Full Name:**
[____________________________________]
**Current Rank/Department:**
[____________________________________]
**Access Request:**
[____________________________________]
**Reason:**
[____________________________________]
**Liability Statement:**
_I, [__________________ (Preferred title and last name), understand and accept any and all liability for any damage I cause to company property and employees either directly or indirectly through acquiring and using my new station access level. By signing this document, I also declare that I am not a designated Enemy of the Company (EoC), affiliated with any organisations designated as EoC and that I have no intention to harm, hinder, or otherwise disrupt the operations of NanoTrasen, its subsidiaries, or its employees without due cause._
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**For Official Use Only**
**Validity Stamp:**
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**(If Denial) Reason:**
[____________________________________]
**Shift Time:**
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**Overseeing Head of Personnel Signature:**
[__________________]
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A-1.1: All Access Request
This is currently a placeholder until a better, funnier form is written.
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there's nothing here
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A-2: Department Transfer Request
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# NanoTrasen Department Transfer Request Form A-2
_This form is to be used in the case that personnel request to transfer from their current department to another._
**A stamped copy of your resume must be stapled to this form. Staplers are provided at the HoP office.**
**Index No. [____]** _(Official use only)_
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**For Applicant's Input**
_Please fill out the underlined areas with a pen._
**Full Name:**
[____________________________________]
**Current Job Title (Example: Medical Doctor):**
[____________________________________]
**Current Department (Example: Medical):**
[____________________________________]
**Requested Job Title:**
[____________________________________]
**Requested Department:**
[____________________________________]
**Relevant Department Head Name:**
[____________________________________]
**Relevant Department Head Approval Stamp:**
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**Reason:**
[____________________________________]
**Liability Statement:**
_I, [__________________] (Preferred title and last name), understand and accept any and all liability for any damage I cause to company property and employees either directly or indirectly through transferring between departments. By signing this document, I also declare that I am not a designated Enemy of the Company (EoC), affiliated with any organisations designated as EoC and that I have no intention to harm, hinder, or otherwise disrupt the operations of NanoTrasen, its subsidiaries, or its employees without due cause._
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**For Official Use Only**
**Validity Stamp:**
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**(If Denial) Reason:**
[____________________________________]
**Shift Time:**
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**Overseeing Head of Personnel Signature:**
[__________________]
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A-3: Employee Termination Form
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# NanoTrasen Employment Termination Form A-3
_This form is to be used in the case that personnel must be stripped of their position within NanoTrasen. Only the relevant Heads of Department, the Captain, or - in extrenuous circumstances - security personnel can legally request these._
**Index No. [____** _(Official use only)_
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**For Applicant's Input**
_Please fill out the underlined areas with a pen._
**Full Name of Employee:**
[____________________________________]
**Employee's Current Job Title:**
[____________________________________]
**Employee's Current Department:**
[____________________________________]
**Head of Department/Applicant's Name:**
[____________________________________]
**Reason:**
[____________________________________]
**Demotion to Staff Assistant? (Y/N):** [_]
**(If above is no) Demotion To:**
[____________________________________]
**Liability Statement:**
_I, [__________________] (Preferred title and last name), understand and accept any and all liability for any damage I cause to company property and employees either directly or indirectly through stripping the above employee of their position. I uphold that this decision is within the best interests of NanoTrasen, this orbital/nautical installation, and its employees. By signing this document, I also declare that I am not a designated Enemy of the Company (EoC), affiliated with any organisations designated as EoC and that I have no intention to harm, hinder, or otherwise disrupt the operations of NanoTrasen, its subsidiaries, or its employees without due cause._
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**For Official Use Only**
**Shift Time:**
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**Overseeing Head of Personnel Signature:**
[__________________]
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B-Series: Payroll and Budget
B-1: Payment Adjustment Request
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# NanoTrasen Payment Adjustment Request Form B-1
_This form is to be used in the case that personnel requests a raise in their wages, or a Department Head requests to adjust an employee's wages._
**Index No. [____]** _(Official use only)_
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**For Applicant's Input**
_Please fill out the underlined areas with a pen._
**Full Name of Employee:**
[____________________________________]
**Current Rank/Department:**
[____________________________________]
**Head of Department's Name (If applicable):**
[____________________________________]
**Head of Department's Jurisdiction (Civilian, Engineering, Command, etc.)**
[____________________________________]
**Amount/Percentage Change (Can be positive or negative)**
[__________________]
**Reason:**
[____________________________________]
**Liability Statement:**
_I, [__________________] (Preferred title and last name), understand and accept any and all liability for any damage I cause to company property and employees either directly or indirectly through changing the payroll of myself or an employee under my jurisdiction. I wholeheartedly believe that the payroll adjustment is necessary and deserved for my or my subordinate's conduct. By signing this document, I also declare that I am not a designated Enemy of the Company (EoC), affiliated with any organisations designated as EoC and that I have no intention to harm, hinder, or otherwise disrupt the operations of NanoTrasen, its subsidiaries, or its employees without due cause._
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**For Official Use Only**
**Validity Stamp:**
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**(If Denial) Reason:**
[____________________________________]
**Shift Time:**
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**Overseeing Head of Personnel Signature:**
[__________________]
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B-2: Budget Transfer Record
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# NanoTrasen Budget Transfer Record Form B-2
_This form is to be used if the Head of Personnel or another member of Command moves funds between departments. This is used for internal record-keeping, anti-corruption efforts, and transparency._
**Index No. [____]** _(Official use only)_
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**For Official Use Only**
_Please fill out the underlined areas with a pen._
**From Account (Eg: Shipping, Payroll):**
[____________________________________]
**To Account:**
[____________________________________]
**Amount ($):**
[__________________]
**Liability Statement:**
_I, [__________________] (Preferred title and last name), understand and accept any and all liability for any damage I cause to company property and employees either directly or indirectly through transferring funds between the different station accounts. I assert that this move is within the best interests of NanoTrasen, this orbital/nautical installation, or its crew. By signing this document, I also declare that I am not a designated Enemy of the Company (EoC), affiliated with any organisations designated as EoC and that I have no intention to harm, hinder, or otherwise disrupt the operations of NanoTrasen, its subsidiaries, or its employees without due cause._
**Shift Time:**
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**Overseeing Head of Personnel Signature:**
[__________________]
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C-Series: Equipment and Permits
C-1: Equipment Requisition Request
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# NanoTrasen Equipment Requisition Request Form C-1
_This form is to be used in the case that personnel requests any equipment that is not expressly from their department or level of access._
**NOTE - ANY SECURITY/COMMAND OR ANY HIGH-RISK/SENSITIVE ITEM REQUESTS WILL BE SUBJECT TO FURTHER SCRUTINY, AND SUCH REQUESTS WILL BE REVOKED IF YOU HAVE A PRIOR CRIMINAL RECORD OR THERE IS REASONABLE SUSPICION OF ILLEGAL ACTIVITY, PER A COMMAND DECISION.**
**Index No. [____]** _(Official use only)_
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**For Applicant's Input**
_Please fill out the underlined areas with a pen._
**Full Name:**
[____________________________________]
**Current Rank/Department:**
[____________________________________]
**Item Request:**
[____________________________________]
**Approval by Relevant Head of Department (If applicable)**
[____________________________________]
**Reason:**
[____________________________________]
**Liability Statement:**
_I, [__________________] (Preferred title and last name), understand and accept any and all liability for any damage I cause to company property and employees either directly or indirectly through gaining access to the requested item. By signing this document, I also declare that I am not a designated Enemy of the Company (EoC), affiliated with any organisations designated as EoC and that I have no intention to harm, hinder, or otherwise disrupt the operations of NanoTrasen, its subsidiaries, or its employees without due cause._
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**For Official Use Only**
**Validity Stamp:**
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**(If Denial) Reason:**
[____________________________________]
**Shift Time:**
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**Overseeing Head of Personnel Signature:**
[__________________]
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C-2: ID Replacement Request
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# NanoTrasen ID Replacement Request Form C-2
_This form is to be used in the case that personnel lose their ID and request a replacement._
**NOTE - FOR THE PURPOSE OF STATION SECURITY, PROOF MUST BE PROVIDED OF THEIR PRIOR ACCESS LEVEL FOR APPROVAL. IF THIS IS NOT POSSIBLE, ONLY CIVILIAN ID REQUESTS WILL BE APPROVED.**
**Index No. [____]** _(Official use only)_
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**For Applicant's Input**
_Please fill out the underlined areas with a pen._
**Full Name:**
[____________________________________]
**Department/Desired Access Level:**
[____________________________________]
**Replace PDA? (Y/N):**
[_]
_If a PDA must be replaced, a separate C-2.1 form must be signed in conjunction and stapled to this document._
**Reason:**
[____________________________________]
**Liability Statement:**
_I, [__________________] (Preferred title and last name), understand and accept any and all liability for any damage I cause to company property and employees either directly or indirectly through gaining a new ID. I uphold that the desired access level of my new ID is identical to that of my previous access level or that I am not gaining any non-civilian access through this action. By signing this document, I also declare that I am not a designated Enemy of the Company (EoC), affiliated with any organisations designated as EoC and that I have no intention to harm, hinder, or otherwise disrupt the operations of NanoTrasen, its subsidiaries, or its employees without due cause._
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**For Official Use Only**
**Validity Stamp:**
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**(If Denial) Reason:**
[____________________________________]
**Shift Time:**
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**Overseeing Head of Personnel Signature:**
[__________________]
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C-2.1: PDA Replacement Request
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# NanoTrasen PDA Replacement Request Form C-2.1
_This form is to be used in the case that personnel lose their PDA and request a replacement. PDAs will be covered at cost by Station Command._
**Index No. [____]** _(Official use only)_
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**For Applicant's Input**
_Please fill out the underlined areas with a pen._
**Full Name:**
[____________________________________]
**Department/Access Level:**
[____________________________________]
**Please Input any Desired PDA Cartridges Below:**
[____________________________________]
**Reason:**
[____________________________________]
**Liability Statement:**
_I, [__________________] (Preferred title and last name), understand and accept any and all liability for any damage I cause to company property and employees either directly or indirectly through gaining a new PDA. By signing this document, I also declare that I am not a designated Enemy of the Company (EoC), affiliated with any organisations designated as EoC and that I have no intention to harm, hinder, or otherwise disrupt the operations of NanoTrasen, its subsidiaries, or its employees without due cause._
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**For Official Use Only**
**Validity Stamp:**
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**(If Denial) Reason:**
[____________________________________]
**Shift Time:**
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**Overseeing Head of Personnel Signature:**
[__________________]
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C-3: Firearm Permit Request
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# NanoTrasen Firearm Permit Request Form C-3
_This form is to be used in the case that applicable personnel request for security clearance to legally possess firearms._
**NOTE - FOR THE PURPOSE OF STATION SECURITY, APPLICANTS MUST EITHER HAVE JOBS THAT ALREADY POSSESS FIREARMS WITHOUT A LICENCE OR A HOSTILE THREAT MUST POSSESS ENOUGH DANGER TO NANOTRASEN OR ITS PERSONNEL TO WARRANT ARMING NON-SECURITY PERSONNEL. APPLICANTS WITH A CRIMINAL RECORD WILL BE DENIED.**
**Index No. [____]** _(Official use only)_
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**For Applicant's Input**
_Please fill out the underlined areas with a pen._
**Full Name:**
[____________________________________]
**Firearms Registered:**
[____________________________________]
**Reason:**
[____________________________________]
**Liability Statement:**
_I, [__________________] (Preferred title and last name), understand and accept any and all liability for any damage I cause to company property and employees either directly or indirectly through gaining a licence to legally possess firearms. I uphold that I have no prior criminal record and that I will possess and use my firearm(s) responsibly under NanoTrasen corporate law. By signing this document, I also declare that I am not a designated Enemy of the Company (EoC), affiliated with any organisations designated as EoC and that I have no intention to harm, hinder, or otherwise disrupt the operations of NanoTrasen, its subsidiaries, or its employees without due cause._
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**For Official Use Only**
**Validity Stamp:**
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**(If Denial) Reason:**
[____________________________________]
**Shift Time:**
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**Overseeing Head of Personnel Signature:**
[__________________]
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Head of Security/Security Forms
400 Series: Arrests and Searches
401: Arrest Warrant
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# <center>NANOTRASEN OFFICE FOR INTERNAL SECURITY AFFAIRS</center>
**INTERNAL REFERENCE NUMBER: [_____]**
**CASE NUMBER: [_____]**
**FORM 401 - ARREST WARRANT**
Fill out all details below with a pen. This may be authorized by the Head of Security, Command Staff, or - in exceptional circumstances - individual Corporate Security Officers.
**THIS DOCUMENT IS A LEGAL REQUIREMENT OUTSIDE OF STATION EMERGENCIES OR SPONTANEOUS ARREST.**
*By signing this form, you hereby state that you are a lawful member of NanoTrasen's Corporate Law Enforcement Organisation or the Office for Internal Security Affairs and that you are acting within the best interests of NanoTrasen, its law enforcement personnel, and the station's crew.*
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*This document is an official notice, providing NanoTrasen Corporate Security - operating under the legal authority of the NanoTrasen Office for Internal Security Affairs - permission to legally detain, search, and charge individuals in their area of operations.*
*In accordance with NanoTrasen regulations, the individual to be detained is to be verbally informed of their arrest. A complete, approved, and signed copy of their arrest warrant is to be presented for them to read before they may be legally detained. It will be expected of detainees to comply with the directions of NanoTrasen Corporate Security Officers.*
_**Should they attempt to flee or resist, additional charges of resisting arrest are to be applied.**_
_**Should others attempt to interfere with a lawful arrest, they are to be detained on charges of aiding and abetting.**_
_**Should the Security personnel conducting this arrest fail to follow NanoTrasen regulations in the conduct of the arrest, they are to be subject to disciplinary action or charges of illegal detainment.**_
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**DETAILS**
**NAME:**
[____________________________________]
**CHARGES:**
[____________________________________]
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**CURRENT SHIFT TIME:**
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**APPROVAL STAMP:**
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**AUTHORIZED BY (SIGNATURE):**
[_______________]
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402: Search Warrant
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# <center>NANOTRASEN OFFICE FOR INTERNAL SECURITY AFFAIRS</center>
**INTERNAL REFERENCE NUMBER: [_____]**
**CASE NUMBER: [_____]**
**FORM 401 - SEARCH WARRANT**
Fill out all details below with a pen. This may be authorized by the Head of Security, Command Staff, or - in exceptional circumstances - individual Corporate Security Officers.
**THIS DOCUMENT IS A LEGAL REQUIREMENT FOR LOCATION OR NON-ARREST RELATED SEARCHES OUTSIDE OF STATION EMERGENCIES.**
*By signing this form, you hereby state that you are a lawful member of NanoTrasen's Corporate Law Enforcement Organisation or the Office for Internal Security Affairs and that you are acting within the best interests of NanoTrasen, its law enforcement personnel, and the station's crew.*
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*This document is an official notice, providing NanoTrasen Corporate Security - operating under the legal authority of the NanoTrasen Office for Internal Security Affairs - permission to legally search and confiscate from individuals, locations, or departments in their area of operations.*
*In accordance with NanoTrasen regulations, the individual or individuals in the location or department are to be verbally informed of the search. A complete, approved, and signed copy of the search warrant is to be presented for them to read before they may be legally searched. It will be expected of the searched subjects or department to comply with the directions of NanoTrasen Corporate Security Officers.*
*Items that are considered contraband through NanoTrasen Space Law or the decree of Central/Station Command may be seized from the subject, premises, or department.*
_**Searches of individuals are only permitted within Security areas or low-traffic, secure areas.**_
_**Should search efforts be impeded, the impeding individuals are to be immediately taken into custody and charged with the obstruction of legally sanctioned security activities.**_
_**Security Officers are obligated to take confiscated items into Confiscated Items or evidence storage.**_
_**Outside of station emergencies, a relevant Head of Department has the legal authority to unilaterally order a search of their department to cease.**_
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**DETAILS**
**NAME OF INDIVIDUAL/LOCATION/DEPARTMENT:**
[____________________________________]
**REASONS:**
[____________________________________]
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**CURRENT SHIFT TIME:**
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**APPROVAL STAMP:**
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**AUTHORIZED BY (SIGNATURE):**
[_______________]
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500 Series: Sentencing and Punishment
501: Sentencing (Mutually exclusive with 502)
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# <center>NANOTRASEN OFFICE FOR INTERNAL SECURITY AFFAIRS</center>
**INTERNAL REFERENCE NUMBER: [____]
CASE NUMBER: [____]
FORM 501 - SENTENCING**
Fill out all details below with a pen. This may be authorized by all Corporate Security personnel. 502 is mutually exclusive with this form.
_By signing this form, you hereby state that you are a lawful member of NanoTrasen's Corporate Law Enforcement Organisation or the Office for Internal Security Affairs and that you are acting within the best interests of NanoTrasen, its law enforcement personnel, and the station's crew._
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**DETAILS**
**NAME OF DETAINEE:**
[____________________________________]
**JOB TITLE OF DETAINEE:**
[____________________________________]
**DEPARTMENT OF DETAINEE:**
[____________________________________]
**CHARGES:**
[____________________________________]
**SENTENCE:**
[____________________________________]
**CURRENT SHIFT TIME:**
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**PERSONNEL**
**ARRESTING OFFICER:**
[____________________________________]
**PROCESSING OFFICER (IF DIFFERING FROM ARRESTING OFFICER):**
[____________________________________]
**APPROVAL STAMP:**
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**SIGNATURE OF PROCESSING OFFICER/HoS:**
[_______________]
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502: Execution Order (Mutually exclusive with 501)
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# <center>NANOTRASEN OFFICE FOR INTERNAL SECURITY AFFAIRS</center>
**INTERNAL REFERENCE NUMBER: [____]
CASE NUMBER: [____]
FORM 502 - EXECUTION ORDER**
Fill out all details below with a pen. This may be authorized the Head of Security, the Captain, or - in special cases where neither are available - individual Security operatives (Including NanoTrasen Security/Special Operatives). This is a separate document from 501 and they are mutually exclusive.
_By signing this form, you hereby state that you are a lawful member of NanoTrasen's Corporate Law Enforcement Organisation or the Office for Internal Security Affairs and that you are acting within the best interests of NanoTrasen, its law enforcement personnel, and the station's crew. You accept any and all legal liability as a result of condemning a detainee to death._
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**DETAILS**
**NAME OF DETAINEE:**
[____________________________________]
**JOB TITLE OF DETAINEE:**
[____________________________________]
**DEPARTMENT OF DETAINEE:**
[____________________________________]
**CHARGES:**
[____________________________________]
**METHOD OF EXECUTION:**
[____________________________________]
**EXECUTIONER (IF APPLICABLE):**
[____________________________________]
**CYBORGIFICATION? (Y/N):** [_
**BODY DISPOSAL METHOD:**
[____________________________________]
**CURRENT SHIFT TIME:**
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**PERSONNEL**
**ARRESTING OFFICER:**
[____________________________________]
**PROCESSING OFFICER (IF DIFFERING FROM ARRESTING OFFICER):**
[____________________________________]
**APPROVAL STAMP:**
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**SIGNATURE OF AUTHORISED PERSON/HoS:**
[_______________]
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600 Series: Evidence Gathering and Forensics
601: Witness Statement
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# <center>NANOTRASEN OFFICE FOR INTERNAL SECURITY AFFAIRS</center>
**INTERNAL REFERENCE NUMBER: [____]
CASE NUMBER: [____]
FORM 601 - WITNESS STATEMENT**
Fill out all details below with a pen.
_By signing this form, you hereby swear that your statement is the truth and nothing but. Knowingly entering false or misleading information will be punished with the full force of NanoTrasen Space Law._
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**DETAILS
NOTE: A SECURITY OFFICER/OPERATIVE MUST FILL OUT THIS SECTION. THE WITNESS STATEMENT SECTION FOLLOWS LATER.**
**WITNESS NAME:**
[____________________________________]
**WITNESS JOB TITLE:**
[____________________________________]
**WITNESS DEPARTMENT:**
[____________________________________]
**OVERSEEING OFFICER NAME:**
[____________________________________]
**OVERSEEING OFFICER JOB TITLE:**
[____________________________________]
**SHIFT TIME: **
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**WITNESS STATEMENT IS TO BE WRITTEN BELOW:**
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602: Evidence Record
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# <center>NANOTRASEN OFFICE FOR INTERNAL SECURITY AFFAIRS</center>
**INTERNAL REFERENCE NUMBER: [____]
CASE NUMBER: [____]
FORM 602 - EVIDENCE RECORD**
Fill out all details below with a pen.
_By signing this form, you hereby swear that your statement is the truth and nothing but. Knowingly entering false or misleading information will be punished with the full force of NanoTrasen Space Law._
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**DETAILS**
**EVIDENCE TYPE:**
[____________________________________]
**PHYSICAL DESCRIPTION:**
[____________________________________]
**COLLECTING OFFICER:**
[____________________________________]
**COLLETING OFFICER JOB TITLE:**
[____________________________________]
**LOCATION FOUND:**
[____________________________________]
**RELEVANCE TO CASE:**
[____________________________________]
**SHIFT TIME: **
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**RELEVANT FORENSIC DATA AND OTHER DETAILS TO BE ENTERED BELOW:**
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603: Case Report
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# <center>NANOTRASEN OFFICE FOR INTERNAL SECURITY AFFAIRS</center>
**INTERNAL REFERENCE NUMBER: [____]
CASE NUMBER: [____]
FORM 603 - CASE REPORT**
Fill out all details below with a pen.
_By signing this form, you hereby swear that your statement is the truth and nothing but. Knowingly entering false or misleading information will be punished with the full force of NanoTrasen Space Law._
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**DETAILS
**OVERSEEING OFFICER NAME:**
[____________________________________]
**OVERSEEING OFFICER JOB TITLE:**
[____________________________________]
**SHIFT TIME: **
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**REPORT IS TO BE WRITTEN BELOW:**
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Medical Director/Medical Forms
Medical Diagnoses/Emergencies
Major Medical Emergency Record
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# <center>NanoTrasen Medical Association</center>
_<center>Vivamus moriendum est</center>_
___
**<center>Index No. [____]** _(Official use only)</center>_
**<center>Major Medical Emergency Record**
To be used for major medical emergencies with a poor prognosis or for otherwise exceptional circumstances. This may be admitted as evidence in a NanoTrasen Court of Space Law. Knowingly entering false details may result in the disqualification of the attending physician from medical practice.</center>
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**Please enter details below on the lines with a pen.**
**Name:**
[____________________________________]
**Vitals:**
**(OXY)[___] (TOX)[___] (BUR)[___] (BTE)[___]**
**(BRAIN Y/N)[_]**
**Active Medical Issues:**
[____________________________________]
**Reagents Found:**
[____________________________________]
**Organ Condition:**
[____________________________________]
**Administered Medication:**
[____________________________________]
**Time of Death (If Applicable):** [_____]
**Cloned? (Y/N):** [_]
**Cyborgification? (Y/N):** [_]
**Morgued? (Y/N):** [_]
**(If previous three are N) Body Condition**
[____________________________________]
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**Shift Time:**
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**Physician's Signature:**
[_______________]
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Surgical Procedures
Elective Surgery Consent Form
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# <center>NanoTrasen Medical Association</center>
_<center>Vivamus moriendum est</center>_
___
**<center>Index No. [____]** _(Official use only)_</center>
**<center>Elective Surgery Consent Form**</center>
<center>To be used for elective/voluntary non-essential surgical procedures.</center>
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_I, the undersigned, hereby grant the medical department aboard the station to which I am based permission to conduct an elective surgical procedure on myself. I understand that I have the right to end the procedure at any time while I am lucid. I understand that I also have the right to refuse or use general or local anesthetic. Should I perish, sustain any medical injury, or gain an adverse medical condition in the unfortunate event that the procedure catastrophically fails, I forfeit the right to bring forth legal action against NanoTrasen, the NanoTrasen Medical Association (NMA), or the individual surgeons and physicians involved. I understand that this procedure is not medically necessary and therefore understand that my procedure may not be the current priority of or in the best interests of myself or the employees of the NMA. I understand that, outside of special circumstances as dictated by the Medical Director, Station Command, or Central Command, the procedure may not involve any activities or items deemed illicit under NanoTrasen Space Law. I also declare that I am not a designated Enemy of the Company (EoC), affiliated with any organisations designated as EoC and that I have no intention to harm, hinder, or otherwise disrupt the operations of NanoTrasen, its subsidiaries, or its employees without due cause._
**Name:**
[____________________________________]
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**Attending Physician is to enter details below on the lines with a pen.**
**Procedure:**
[____________________________________]
**Shift Time:**
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**Physician's Signature:**
[_______________]
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