PATIENT INFORMATION: Name: FIRST NAME the ADJECTIVE, ROYAL TITLE of the PLACE and PLURAL NOUN. Estimated time of death: When the PLURAL NOUN PLURAL VERB at TIME OF DAY. Gender: ADJECTIVE NOUN. Emergency contact: CELEBRITY NAME. CONCERNS AND SYMPTOMS - Please describe, in brief, the problem for which you wish assistance from the wizard. "My NOUN has been VERB ENDING IN 'ING' since last NAME OF A HOLIDAY. At first I wasn't EMOTION, but then it started VERB ENDING IN 'ING' AD VERB. My friend PERSONS NAME recommended your potions after you helped them with their COLOR BODY PART." TERMS AND CONDITIONS: Upon your (distant and eventual) death and in payment for any and all services rendered, your body will be posthumously delivered to the wizard's ADJECTIVE workshop. We guarantee your remains will be PAST TENSE VERB with respect, though by that time it is unlikely you will notice or care how we PLURAL VERB the meatsuit you are VERB ENDING IN 'ING' in presently.
