DOC request three complete - Cannabis Defense Coalition

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STATE OF WASHINGTON 'DEPARTMENT OF CORRECTIONS Medicinal Use of Marijuana Verification OFFENDER I.D. DATA: RECEIVED APR 272009 D"ept of Corrections Health Services Dear Prescriber, By state statute the Washington State Department of Corrections is charged with the responsibility to supervise some . offenders after they have been convicted of a felony. The above named· patient is currently under supervision by the Department. Supervision is designed to help the offender avoid those environments or situations that lead to their 9riminal behavior. Often illicit drug .use is a contributing factor in an individual's criminafity. Accordingly it's usual that the court or the Depa'rtment of Corrections will impose a condition of supervision that the offender not use, or possess illiCit drugs, including marijuana. This offender has claimed that they have a condition'for which the medicinal use of marijuana has been recommended. The below Verification is to determine the legitimacy of their claim. Thank you in advance for you~ assistance. If you have questions, please contact the Community Corrections Assistant Secretary at (360) 725-8787. 1. Is this patient under your care 6jYes DNo 2. Are you recommending medical marijuana for this patient due to a diagnqsis of Acquired Immunodeficiency Syndrome (AIDS) 3. a. If the answer to question 2 is "Yes", does he/she have anorexia b. If the answer to question Are you recommending medic associated with cancer chem l a. If the answer to questi( antiemetic treatments' l . ~~rl1cL\ " -I",,,!s he/she have weight loss (0 naUsea and vomiting ,d to respond to conventional DYes DYes DYes DYes DYes b. If the answer to quesf ~ttt)~~ "'hat those treatments were (meaication, dose, duration): . i . I c. What is the planned i gNo DNo DNo ,r.' [1J No DNo \ . 4. If you answered "No" to items 2 &13 above, what is the reason you are recolTlmending medicinal use of marijuana . \ ~" . c.....'I\.0J7.:J ~lc... ~.", a. Please provide evidence published in a peer-reviewed scientific publication to support the medicinal use of marijuana for this purpose. I . I 5. The patient's accompanying Release of Information authorizes you to provide the Department with current and future information related to this issue. '00 you agree to notify the Department's Medical Director of any changes in your answers above DYes ~o <strong>DOC</strong> 14-053 (Rev. 3/16/09) . - <strong>DOC</strong> 380.200 I I PDU-6655-3 000229
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STATE OF WASHINGTON DEPARTMENT OF C
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RECORDS PROVIDED WITH REDACTIONS ~~
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(".- " ~"""'":.~ Inr ... ~ STATEOFW
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i ( Documentation of Physician Auth
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Distefano, Monica J. (DOC) From: Se
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eRR Medical, Il1c 3115 E. Mission A
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Fax : ' 3115,E. Mission Ave Spokane
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Or-FENDER 1.0. DATA, j' STATE OF WA
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DoCumentation of Medical AuthoriZat
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STATE OF WASHINGTON DEPA'RTMENTOF C
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j I Documentation of MedicarAuthcir
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Chapter 69.51 A RCW: Medical marij1
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OFFENDER 1.0. DATA: STATE OF WASHIN
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. ! STATE OF WASHINGTON DEPARTMENT
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STATE OF WASHINGTON .DEPARTMENT OF
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Wheeler, Judine L. (DOC) From: Sent
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Prescdbar's Name (pnnt) . Prasc~jje
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Interpretation of Medical Marijuana
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From: Sent: To: Duggan, Brenda J. (
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NIELSEN TO COME UPSTAIRS. CCO NIELS
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Date & Tirpe Created: 12/16/2008 11
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PRIMARY CARE PHYSICIAN AND LOOKED O
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I FW: 380200 Community Supervision
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