craaazyisland: (Awkward turtle)

PATIENT MEDICAL HISTORY
Name: Steve Burnside Age: ~18 years Sex: Male Height: 68 inches/ 172 cm Weight: 149 lbs / 67 kg
[ ] Magical by nature/practices magic. [ ] Can't have magic used on. [X] Contagious (see notes).
Human (Veronica)
Average Lifespan: 60-80 years Rate of Maturity: 18-20 years Average age of Puberty: 13-16 years

Normal Diet: Omnivorous

Common Ailments:
[List of common ailments goes here.]
Specific Notes:
- Patient is infected with the T-Veronica virus [Attachment: Notes on T-Veronica]
GENERAL HEALTH
All of the following sense-related questions are to be answered in comparison to an average Homo sapiens. Ask your medical provider for assistance in answering this section.
Blood Pressure: [X] Average | [ ] Low | [ ] High
Vision: [X] Fine | [ ] Near Sighted | [ ] Far Sighted | [ ] Enhanced
If Enhanced, further explain:
Hearing: [ ] Deaf | [ ] Low | [X] Average | [ ] High Range | [ ] Low Range | [ ] Extremely Sensitive
If necessary, further explain:
Smell: [ ] Cannot Smell | [ ] Low | [X] Average | [ ] High | [ ] Extremely Sensitive
If Extremely Sensitive, further explain:
Known Allergies:

Are there any potential complications with healing processes we should be aware of when treating you?: Yeah, my friggin' blood lights on fire. That's probably something you should be aware of.

Do you have a healing factor different from the average for your species? If so, explain how here: If the virus is active I can heal from almost anything in a few seconds. So, uh... that shouldn't be a problem, right?

Have you recently been screened for species, sex, and age specific cancer risks?: Cancer is the least of my goddamn worries, okay?

Special notes on care: (Such as contagious diseases/conditions, special means of handling, special care taken in handling)
- Patient is infected with T-Veronica virus, a highly volatile mutagen which causes a variety of side effects. Left unchecked, patient is at risk of mutation into "Tyrant." Extreme care must be taken when working with patient.
- Blood ignites upon exposure to oxygen. Burns from blood are at risk of infection from virus, please use extreme caution in handling patient's injuries.
Record of Past Injuries:
Multiple gunshot wounds; malnutrition; abdominal impalement
Ship Health Records:
Veronica mutation, stage 1 (skin discoloration); Veronica mutation, stage 2 (skin discoloration, iris discoloration, mutation of hand and finger bones, development of inhuman extremities); Veronica mutation, stage 3 (full body mutation and mental state alteration); multiple gunshot wounds
SEXUAL HEALTH
Have you ever been sexually active?: NO!
Are you currently Sexually Active: NO NO NO
Have you recently been screened for STIs?:
NO!!
Species specific sexually related health notes and/or issues:
Reproductive Health (skip if N/A)
Date of Last Menses/Estrus/Equiv (skip if n/a):
Number of pregnancies:
Number of pregnancies carried to term:
Age of first birth/hatching/etc. (if applicable):
Total number of births/hatching/etc.:
DRUGS AND MEDICATION
Are you or should you be on any prescribed medication? If so, list below:
- Biweekly T-Veronica treatments in Contagion to nullify infection and mutation risk
Have you taken any recreational or non-prescribed drugs or substances in the past? Is so, please list them and their frequency of use below:

No
Do you currently take any recreational or non-prescribed drugs or substances? Is so, please list them and their frequency of use below:
No

Profile

craaazyisland: (Default)
Steve Burnside

October 2012

S M T W T F S
 123456
78 910111213
14151617181920
21222324252627
28293031   

Style Credit

Expand Cut Tags

No cut tags
Page generated Jun. 11th, 2025 01:01 am
Powered by Dreamwidth Studios