Please provide the information requested, and paste this into a notecard and send it to Gently Sleeps.

PD Doctor Application Form

Name: 
Date: 

PD SIM: 
Group/Crew: 
Native/Western: 

Timezone: 
Typical SL times on: 

Are you already a doctor here? : 

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Pirates Destiny is reassigning doctors in the estate, our existing list will be cleared.
Anyone who wants to be, or continue to be, a doctor needs to send this notecard application to Gently.
This also applies to any existing doctors in Pirates Destiny.

Gently Sleeps (AllYourBaseAreBelongToUs Resident)