2019-01-23_msilverman_Waiver for Jaqueline McCartney.pdf

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Jaqueline McCartney
 
174 Rue Goyer
 
Chateauguay, QC
 
J6K 2L2
 
 
 
 
The family of Jaqueline McCartney agrees to waive all responsibility in relation to insulin
 
injections in the event of an emergency. HCA acknowledges that Anita Fice will measure the
 
same quantity of insulin and present it to the client to inject herself. If Anita is unsure she will
 
contact the client’s daughter Tricia for assistance over the phone if a judgement call must be
 
made.
 
 
 
 
 
 
 
 
________________________                          ________________________
 
Family Signature
Date