-Ars CurandiInformed Consent form for the Reflexivity Research Center

This Consent form is for all participants who are interesting in volunteering for
clinical trials involving Compound 176-4U for the purposes of self interview.
Willing Participants are to fill out this form PRIOR to all procedures and will
not be admitted into the facility (as a voluntary participant) without having this
form completed.
Dr. Aaron Lysander M.D. Biochemistry
Ars Curandi
I am Dr. Lysander, creator of Compound 176-4U which allows the human
neural interface to successfully connect and transmit into digital space. I am calling
upon volunteers to submit to simple procedures to test the effectiveness of this
chemical compound as a tool for mental health. I hesitate to call it a drug, as the
compound itself is not of much use. Rather the function it provides is much more
interesting.
Once a subject has been input with Compound 176-4U, the synapses in the
brain react in a way that a computer can receive the waves emitted via bluetooth
frequency and synchronize to the system. The computer can then completely
communicate with the human mind and interact back and forth as though it were
physically connected.
Our goal is to have the human mind interface with a computer for the
purposes of self psychological counseling. The idea of ''Reflexivity of Human
Consciousness'' was introduced to me as I was working on a formula that would
allow medical equipment to further analyze the brain patterns of physically
paralyzed patients. The result of that lucky co-incidence was this amazing result.
We now have the ability to temporarily upload a live human consciousness onto a
computer.
The research procedures will be simple. While the subject (you) is being
broadcast onto the server, the computer will scan past memories to create a digital

Page 1 of 5

replica of yourself that will be able to converse with you as though it were you from
a younger age.
From there on, we will allow you to conduct several interviews with your
younger self for whatever purposes you may feel necessary, in order to further
enhance your own current life. A file will be created for you and at the end of the
test period you will have access to the entire series of interactions you've had over
the course of the study.
I look forward to seeing all of you volunteers within our facility to bravely
explore this new frontier of human development and to expand the understanding
of our existence.
--Aaron Lysander.

-CLAUSES1. The clinical trials will include an injection of the compound, along with a
subsequent interview. These will occur weekly over the course of several
months. Besides the clinical trials, we will have trained professionals on site
to administer traditional mental health if the subjects feel that they need it.
We aim to treat our volunteers with the highest level of care on all fronts. Your
participation is vital and therefore we will do our best to accommodate you
and your needs.
2. Your participation in this research is entirely voluntary. It is your choice
whether to participate or not. You may not change your mind later and stop
participating if you agreed earlier (by turning in this application).

-About [Compound 176-4U]1) The compound is a fully realized formula that has cleared animal testing and is
ready for human trials as approved by the FDA
2) The formula has been patented to Dr. Aaron Lysander M.D. Its formula will not,
under any circumstances be released to the test subjects or anyone beyond the
facility.
3) The compound has been found to be completely stable and has had no
significant side-effects as shown by it's test results.
4) For the duration of this trial we are seeking healthy individuals that are not
currently suffering from/require the following: a) hospitalization b) medication c)

Page 2 of 5

food allergies/allergies d) medical marijuana e) rehabilitation (such as cigarette,

alcohol or other addictions).

-Procedures and ProtocolThe following procedures will be standard for all patients.
1. Considering the nature of the compound, we will be testing for the most
sensitive neural signatures, as well as effectiveness of Compound 176-4U.
2. The subjects will be tested once weekly, for a period of six weeks, over
which the sessions will be recorded digitally for observation purposes.
3. Once the trial period is over for the volunteer, their file will be released to
them under the conditions given below.
Once you are in possession of your digital file, you will be given the
option of a) disregarding your information and deleting your file, or b) leaving
it with us to archive, but have permanent access to it through our facility, the
Reflexivity Research Center.
4. The testing will involve a high level of secrecy. By agreeing to volunteer for
Ars Curandi's research, you are agreeing to a non-disclosure agreement,
inherently integrated into this volunteer application form. If and when this
application is put to review, if you are uncomfortable with this, you may
withdraw from the clinical trials, before the first trial.
5. Once you have begun the first set of trial weeks, you are no longer allowed
to withdraw your participation, and must thereon keep all activities engaged
within the facility to your self.
6. Again, by agreeing to being a subject for these clinical trials through means
of this application, you are agreeing not to disclose ANY information from
within the duration of the testing.
7. Once your sixth trial is completed, there will be a de-briefing consultation
one week after completion. Here, we will allow you to make the choice detailed
in number 3.
8. The compound will be administered intravenously, via hypodermic needle.
As of the first batch of trials, there has not been an effective pill form of
Compound 176-4U.

Page 3 of 5

There have been no significant side-effects of Compound 176-4U beyond the

soreness of application via hypodermic syringe. Risk factors for any
psychological trauma include:
-Depression
-History of self-harm
-Psychosis
-Anxiety
-Mood swings
-Alcoholism
-Medication Abuse
9. The benefits of this study will be a comprehensive psycho-therapy of
oneself, allowing for closure of past events, and possibly discovering the
cause of events which affect the subject's present psychological state.
(Talking to yourself can be beneficial to learning more about yourself in a
positive way.)
10. All information recorded will stay within the Reflexivity Research Center
and we will archive it on our servers. Your information will never be released
to the public, and once your trial period is over, you will be given a chance to
review your own file. At that point, you will be directed to the choice detailed
in number 3. Rest assured, you will have access to the information in the
future, after we verify that your information matches our record.

Page 4 of 5

I have read the foregoing information and the questions I have asked, have
been answered to my satisfaction. I hereby give my consent and agree to be a
participant in this research.
Print Name of Participant__________________
Signature of Participant ___________________
Date ___________________________
Day/month/year

I have witnessed the accurate reading of the consent form to the potential
participant, and the individual has had the opportunity to ask questions. I
confirm that the individual has given consent freely.
Print name of witness_____________________

AND

Thumb print of

participant
Signature of witness ______________________
Date ________________________
Day/month/year

Statement by the researcher/person taking consent

I confirm that the participant was given answers to questions about the study,
and all the questions asked were answered correctly and to the best of my
ability. I confirm that the individual has not been coerced into giving consent,
and the consent has been given freely and voluntarily.
A copy of this ICF has been input into the patients file for safekeeping and
future access.
Print Name of Researcher/person taking the consent
__________________________________________
Signature of Researcher /person taking the consent
__________________________________________

Date ___________________________
Day/month/year

Page 5 of 5