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Springfallendeer — Form- 34-A (Featured in 'The Place')
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Published: 2014-11-25 05:57:06 +0000 UTC; Views: 369; Favourites: 6; Downloads: 0
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Form 34-A
"Promise Of Body Parts And Organs In The Event Of Death"
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"I, ________________ ________________, hereby state that come my inevitable death while working at this establishment, I would like my body to be put to use to ensure the health of the patients that are housed here rather than be disposed of through other means. By signing this form, I accept that whatever funeral I am given come death will not have any corpse to place in the casket. I also accept that my friends, family, and other such loved ones will be given a false tale explaining my death, that would state why it is that there is no body to be buried."
"In signing this, I accept and understand that my body will be taken apart. I accept that my flesh, bones, and organs can and will become food to the residents housed in this establishment"
"In signing, I accept and understand that what is not fed to the patients housed here will be sent to the infirmary for studies, experimentation, and/or involvement in experiments."
"By signing this, I also accept that even if I die through means unrelated to this, my workplace, that my body will be recovered and all of the above shall happen. That I hold no discontent towards my superiors for performing such actions, as I have given them my written consent to do so."
Print Name (Last): _ _ _ _ _ _ _ _ _ _ _
Print Name (First): _ _ _ _ _ _ _ _ _ _ _
Signature (Full name): _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
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Please list below the name(s), if any, of the patient(s) you would like to have access to your remains come your death:
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The patients listed above will be given free access to your corpse come your demise. If any of the above patients are no longer within the facility come your death, then no other patients will be given access in place of them because they have not been listed.
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By signing, I accept everything listed and/or stated on this form
Print Name (Last): _ _ _ _ _ _ _ _ _ _ _
Print Name (First): _ _ _ _ _ _ _ _ _ _ _
Signature (Full name): _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
