DOC request three complete - Cannabis Defense Coalition

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·Dec.23. 2008 5: 07PM CBR Medical Inc. No. 2825 P. 5/33
Document"ation of Medical Authorization to Possess Marijuana
for Medical Purposes in Washington state
PATIENT NAME: __ _ DATE OF BIRT!-I: _982 .
I, Antoine John§..9.!L. I am a physici·an licensed in the State ofWashingtbn
and I am treating the above patient for a tenninal iII!'1~:or a debilitating condltio'n as defined by
RCW 69~51A.010_ " • ,!
I have advised the above named patient abq~l(the pot¢ntial risks and benefits of the medical use
of marijuana. ! have assessed the above named pati\int's medical history and medical Gondition_
It is my medical opinion that the potemiii\r"benefits of.jhe medical use of marijuana may outweigh
the health risks for this patient. ,:/ . ..:/ . .
Physician Name: _----'D::.;r"-.-~A.:..::nt:.;;o.;:.;in'El~,J=oh=n.:..:;s.;:;.on:.!.__ _'__WA License NUrriber:. ___ M_D_O_OO_3_9_0_48-
Date: __..:..1.:.:.1/.::..:02!=2::.:0::.::0~8___
..
Risks al7d benefits of medical marijuana /
Under Washington law, the use of edi¢al marijuana Is' now permissible 'for some patients
with terminal or·debilitating illn~sses_jTh~/law regulating this (RCW a9.51A) allows physicians'
to advise patients about the risks an9 be(iefits of the medical Lise of marijuana_
The medIcal and scientific evide~[;e ;;'upporting the use of medical marijuana remains
controversial in the medical commupity/ Not an health care providers believe that medical
marijuana is safe or effective and s9m~ providers feel that it is a dangerous drug_ .
According to the Washington St*tgl8W the benefits of medical marijuana may include
treating nausea and vomiting from ~emotherapYI AIDS wasting syndrome, severe muscle
spasms frqm multiple sclerosis or o'-Lher spasticity disorders, glaucoma, and some types of
intractable pain. . .
Some of the risks .of medical marijuana may include possible long-term eIfects of the brain in
the areas of memory, coordination and cognition; impairm(mt of the ability to drive or operate
heavy machinery; respiratory damage: possible lung cancer; and physical or psychological
dependence.
Recommendation
As this patient's "60 Day Supply", as stipulated by RCW 69_51A.040 (3)(b) and
WAC 246-/5-010, this Qualifying Patient can reasonably expect to have in 1heir Posession and
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CBR Medical, Inc.
Administrative Office
3115 E_ Mission Ave, Spokane, WA 99202
Spokane: 509"242-8624 Fax:509-340-2710
Seattle: 206-774--6493 Fax: 206--118-66Q9 .
EMERGENCY OR LAW ENFORCEMENT ONLY
CALL 509-570-2886 OR 509-570-6943
PDU-6655-3 000191