STANDARD CONSENT FORM

I, the undersigned, do hereby acknowledge that the air outside may not sustain me, and that I have been fully informed of the attendant risks or complications, which may include drinking polluted water, toxic springs, and oceans, but are not limited to: bleeding requiring blood transfusion or return to surgery for repair; nerve damage; heart, liver, kidney or lung complications and/or in common cases death and cancers; look for rashes, shortness of breath, fetal deformities, cognitive disabilities, changes in health. There is also the possibility of one or more complications arising in the post-Holocene period preventing normal recuperation; in fact, Mother Earth may not heal. These complications include, but are not limited to: long term ventilation, sea level rising, confusion, fluid accumulation of the lungs, drought, pneumonia, landslides, cardiac arrhythmias, an increase in temperature, fever, abnormal laboratory results, ice melt, food shortages. Infection, long term healing and/or scarring may occur and may require further treatment including surgical repair of forests, oceans, archipelagos, sky. Other complications can occur and pose risk and disability to the patient and all living beings. Moreover, I, the undersigned, have been made fully aware and acknowledge that I have been complicit and simultaneously agree that there is science and that no guarantees or assurances have been made to me regarding expected outcomes. The undersigned hereby certifies that the incidences described in this consent form have been discussed with me, including: any adverse reactions that may reasonably be expected to occur; any alternative efficacious methods of treatment, any research, or economic interest. I have been informed of the risk to nature, that there is no acceptable alternative(s) treatment(s), and that the consent agreed upon is that there may be no likelihood of trenchant mitigation or survival.