Mission Statement SWITEC / Encounter Christ / Evansville office of Youth / ADMINISTRATION OF THE PRESCRIBED MEDICATION / /
Person
HANNAH SITZMAN / Jesus Christ / / /
Position
Family Physician / Youth Minister / designated family physician / Bishop / TEC Lay Director / attending physician / /
Product
UNDERSTAND THAT MY SIGNATURE RELIEVES THE TEC PERSONNEL OF ANY AND ALL LIABILITY RELATED TO THE ADMINISTRATION OF THE PRESCRIBED MEDICATION / HEREBY AUTHORIZE PERSONNEL TO ADMINISTER MEDICATION / AUTHORIZATION FOR THE ADMINISTRATION OF MEDICATION / /
Teens Encounter Christ Southwest Indiana TEC The Roman Catholic Diocese of Evansville Office of Youth & Young Adult Formation P.O. Box 4169 Evansville, IN[removed]