[INSENSITIVE GUY]

There is NO legal authority that requires you to fill out this nonsense.It's a bluff.Tear it up and throw it in the trash,THEN SPIT IN THEIR FACE!

[20yearvet]

You forgot to add "go to Jail" If you spit in there face you can and will be charged. Dont Spit, dont yell. Change doctors and when ask why tell them. when they lose the $$ they will get the message.