4/03/30 Admission form for Cayce Hospital:
APPLICATION FOR ADMISSION AS PATIENT TO HOSPITAL OF
ASSOCIATION OF NATIONAL INVESTIGATORS, INC., VIRGINIA BEACH,
VIRGINIA
The undersigned, [
3742], hereby makes application for
admission as a patient to the CAYCE HOSPITAL, owned by
ASSOCIATION OF NATIONAL INVESTIGATORS, INCORPORATED, Virginia
Beach, Virginia, to be treated for: (To be filled in by
physician) Neurasthenia following Flu in 1918.
On consideration of the acceptance of this application the
undersigned agrees to abide by all rules and regulations of
the Institution as promulgated by its officers and
physicians, and hereby, without solicitation or inducement of
any kind whatsoever, applies for treatment in said Hospital
according to the methods and in the manner that may be
prescribed by the officers and physicians in charge of said
Institution, and especially applies for a diagnosis and
treatment according to the CAYCE PLAN OF SCIENTIFIC DIAGNOSIS
AND RESEARCH.
It is especially understood that neither the said
Association, nor any of its officers, physicians or
attendants, employed by or connected with said Hospital,
guarantee any cure or any specific result from the diagnosis
which may be given or the treatment which may be prescribed,
and said parties shall have no liability for any result from
said diagnosis and any treatment which the patient may
receive pursuant to this solicitation, for the malady of
which said patient may be suffering.
The undersigned represents his/her history to be as follows:
Name: [
3742] Age: 33 Sex: Female
Place of Birth: ..., Va.
Married: Yes Husband: [...]
Nearest Relative: Parents, Mr. and Mrs. [...]
Nature of Malady: Neurasthenia
When first apparent: Twelve years ago, approx.
Previous Treatment therefor: Medical and operative
REMARKS: [none]
Date: April 3, 1930
See Source Key File #3742 for Cayce Hospital Charts by Dr.
Lydic, re 3742-1.
4/14/30 See
3742-2.



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