DOC request three complete - Cannabis Defense Coalition

Uec .. LJ. 2UUB ~:2!JPM No. 2826 P. ~/;lU
Documentation of Medical Authorization to Possess Marijuana
for Medi.cal Purposes in Washington State
PATIENT NAME: _.,.-_
DATEOFBIRTH:~
I, Dr. Mohammad H. Said , am a physician licensed in the State of Washington
and I am treating the above patient for a terminal illness or a debilitating condition as defined by
RCW 69.51A.010.
j have Eldvis~d the above named patient abcut the potential risks and b~ilefits of the medical use
of marijuana. I have assessed the above named patient's medical history and medical condition.
ItJs my medical opinion that the potential benefits of the medical use of marijuana may outweigh
the health risks for tI1is patient. .
Physician Name: _--,O::!.f:,.J' M:;.!o:::.:h.!:;a::.!m.::..cm~ao.::d,-,-H~'..:;S:;::ae.::id:....... __ WA License Number: __..;..M_D_O_OO_1_B_3_11_
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PI1ysician .Signature: _. +./;u· ( _-:.....
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I'. f.
·This recommendation expires on: 07f27/2009
Date: __;;;.;07~f2::.:7.;.:f2:.:0:..:.0;:..8___
Rislis and benefits of medical marijuana
Under Washington law, the lise of medical marijuana is now permrssib[e for some patients
with terminal 01' debilitating illnesses. The law regulating this (RCW69.51Aj allows physicians
to advise patients about the risks and benefits of the medical use. of marijuana. .
The medical and scientific evidence supporting the use of medical marijuana remaihs
controversial in tM medical community. Notall Malttl care providers believe that medical
marijuana is safe ot effective and some providers feel that it is a dangerous drug.
Accorcling to tile Washington State·law the benefits of medical marijuana may include
treating nausea and vomiting from chemotllerapy. AIDS wasting syndrome. severs. muscle
spasms from multiple sclerosis or otller spasticity disorders, glaucoma, and some types of
intractable pain. .
Some of the risks of mediCcd marijuana may include possible long-term effects of tile brain in
the areas of memory, coordination and cognition; impairment of the ability to drive or operate
heavy machinery; respiratory damage; possible lung cancer; and physical or psyc.l'Jological
dependence. .
Recommendation
As this patient's "60 day supply", as stipulated by RCW 69.51A(2)(b), I recommend 24 ounces
of dried, cured marijuana and as many plants as the patient feels necessary to maintain this "60
day swppl/'. .
CBR Medical, Inc,
Aclministrative Office
3115 E. Mission Ave
Spokane, WA 99202
Spokane: 509-242-8624
Seattle: 206-774-6493
Revised no·r
PDU-6655-3 000378