Excellent form, thanks for posting it. If 1 in 10 gun owners walked into the doc’s office with it, this practice would stop within a couple of weeks nationwide - word will get around, even if only 1 in 1,000 patients actually presents it to a doc. We have 300,000,000 people, probably at least 1/3 of which see a doc in any given year. Assuming that 1/2 of patients nationwide have a firearm in the home, then 1/6 of the population (roughly 50 million people) who have a firearm in the home will visit a doc in any given year - that’s nearly 1 million per week - let’s see the medical profession ignore THAT.
I would, however, warn anyone who uses that form in a doctor’s office that they may be liable to reimburse the doctor for the cost of a new set of underwear. :>)