Statement of Authorization

 

When we take on a new client, they need to sign a Statement of Authorization so we can legally speak on their behalf, and consult with doctors, pharmacists, or anyone whenever it applies.

 

 Below is a sample of what one would look like, naturally each is different for who we represent.

— The Connecticut Epilepsy Advocate Foundation is a recognized 501 (c) (3) Nonprofit Organization. —

(203) 874-8731​