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03/04/2009 14:08 2064186659 CBR MEDICAL PAGE 05 --.---",--------------:---------~-:------------ Documentation of Medical Authorization to Possess Marijuana for Medical Purposes fn Washington State . PATIENT NAME: ___ ~_~~~~~ __ DATE OF BIRTH:~ I, Dr. Mohammad H_ Said , am a physician licensed in the S~ate of Washington a'nd 1 am treating the above patient for a terminal illness or a debilitating condition as defined by· RCW 69.51A.01 O. I have advised the above named patient about the potential risks and benefits of the medical use of marijuana. I have assessed the above named patient's medical history and medical condition. It is my medical opinion that the potential benefits of the medical use of marijuana may outweigh the health risks for this patient. . . Physician Name: _-.:D:;,:r;,.. M~o:..::ha::.m:..::m.:..:.a::.:d:..H:..:.. :...;' S::.:a~id=--_.,.... WA License Number:. __.;..M_D_O_O_01_8_3_1_1 Physician·Signature: __ . ~p-'A ........ '_·.+H.;....· .._) ..... ·'-·,,_......... This recommendation expires on: 01/0912010. _f ___ Date: 0212112009 Risks and benefits of medical marijuana Under Washington law, the use of medical marijuana: is now PlSrmissible for some patients with terminal or debilitating illnesses. Thl\! law regulating this (RCW 69.51A) allows physicians to advise patients about lhe risks and benefits of the medical use of manjuana. The medicai and scientific evidence supporting the use of medical marijuana remains controversial in the medical community~ Not all Maim ca~ providers believE! that medical marijuana is safe or effective and some providers feel that it is a dangerous drug. According to the Washington State law the benefits of medical marij1,1ana may include treating rl'
. CBR iViedicai, inc •• 3115 E. Mission Ave Spokane, WA 99202 To: MONICA DISTEFANO From: Melissa@cbrmedical.com k ! r \ Fax: 360-586-0252 Date: 04/1012009 Phonal 360-725-8796 Pagas: _Re_: __ -=I1111111=======-___________________ DO __ CIIIII~-_A_PP_~ __ L ________ o Urgent o ~orReview o Please Comment 0 Please Reply . 0 Please Recycle Monica, . Enclosed is the Appeal for the Medicinal Use of Marijua~a for Mr. _ We s.incerely appreciated the time and effort that you personally take in handling these issues on behalf of our patients. We are also in receipt of two letters from the DOC dated February 20 th , 2009 and March 26th, 2009, Please note that the request received' on March 4 th , 2009 is the appeal and not the original request I have also enclosed •••• medical records and his authorization from Dr. Mohammad H. Said and from Dr. Antoine Johnson. Again thanks so much for your time anti effoi1:s. They tmly are app,c;ciated. Sincerely, Melissa Leggee' 509·570-2886 ------------------- ----.--------. .-------"-..--------~---.. CBR Medical, Inc. - 3115 E. Mission Ave, Spokane, Wa 99202' Seattle Phone 206-774-6493 Fax 206-418-6659 Spokane Phone 509-242-8624 Fax 509-340-271 0 Tri-Cities Phone 509-416-2267 Fax 509-340-2710 Vancouver Phone 360-635-6464 Fax 206-418-6659 CONFIDENTIAliTY NOTICE: This communication is intended for the sale Lise of the individual and entity to whom it is addressed, and may contain information that is privileged, or confidential and exempt from disclosLlre under applicable law. YOLI are hereby notified that any dissemination, distribution, or duplication of this communication by someone other than the intended addressee or its designated agent is strictly prohibited. All Infonnation is Protected Under U_S. Federal Law PDU-6655-3 000262
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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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Chapter 69.51 A RCW: Medical marij1
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