Emergency Form – Intergalactic Union

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Your next workcycle starts in:

00:12:59:40

Attention

Due to a system-wide security overhaul some Resources will be taken offline. We apologize for this inconvenience and are working to fix the issue.

Messages

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Citizen Nr.: 8.212.442.567.903

Colony: 82-47-Delta

Star-System: 134

Occupation: System Engineer

Your next workcycle starts in:

00:12:59:40

Attention

Due to a system-wide security overhaul some Resources will be taken offline. We apologize for this inconvenience and are working to fix the issue.

Navigation Menu // Healthcare // Emergency Form

For Medical Emergencies we have added an Emergency Contact Form while the site is down.

Emergency Contact Form

The Intergalactic Union is deeply committed to the health and well-being of every registered citizen. While certain resources remain temporarily unavailable during the ongoing security reboot, urgent medical concerns can still be reported through this official channel. Please complete the form below, and you will receive a notification identifying the appointed medical officer who can assist you as soon as possible.

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Name *

Vorname

Nachname

E-Mail-Adresse *

Reminder: Your permanent IU E-Mail address was assigned at birth or union entry. Please use this official address for all legal and medical matters.

Citizen Number *

Your official Citizen Identification Number is displayed in the IU Browser within your Citizen Status block. Please provide the full sequence as registered. Incomplete or altered numbers may result in denial of service.

Colony *

Your registered Colony and Sector information can be found in the IU Browser under your Citizen Status block. Please ensure your entry matches official records to avoid processing delays.

Species Classification *

For your convenience, the Intergalactic Union Browser provides short species descriptions. These are intended to help you learn, appreciate, and strengthen our shared sense of community and understanding across all member worlds.

below. Name Share

Reported Symptoms (You can select more than one)

Mild Headache / Migraines
Runny Nose / Respiratory Irritation
Dizziness / Fainting Episodes
Gastrointestinal Disturbances (nausea, vomiting, irregular digestion)
Persistent Muscle Weakness / Fatigue
Unusual Skin Discoloration / Rashes
Cognitive Impairment (confusion, memory lapses)
Partial Loss of Sensory Functions (hearing, vision, taste, etc.)
Severe Trauma (open wounds, fractures)
Missing or Severed Limbs
Other (Please discribe your symptoms in the textbox below)

Please indicate all symptoms you are currently experiencing. Failure to provide accurate information may result in delayed or denied assistance.

Add other symptoms you might be experiencing in the textbox below.

Consent to Share Medical and Personal Data *

I hereby consent to the collection, permanent storage, and authorized distribution of my medical and personal data to all relevant Intergalactic Union agencies, including but not limited to the IU Security Forces and affiliated Peacekeeper divisions. I understand that refusal to provide consent will result in the rejection of this emergency request. (Consent is Required)

Messages

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Citizen Nr.: 8.212.442.567.903

Colony: 82-47-Delta

Star-System: 134

Occupation: System Engineer

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