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FEB-18-2009 14:56 From: To:360 586 0252 ~~c_~_: ____________________ ~ 2. AM YQlJ ~bln9 mec!~ mlr~utIl'III ~ hf. pltlent Clut to • dl'"noIIla of AallJlred Iml'!Ml~aflclel'1rJY s~~me (AlI)!) . o. If IhIiJ Qn5\Wt tc ~u .. Uon 2ft 'V.,,", dCCII holt tie hili!! anorexia, Q. If the anuwor tL1 question 2a 10 'Vall', ~G he/llh. havo w.I;ht lollS' 3. Ar~ yOu l:lrellcrlbln£l m.dlcal mMQu.n.1cr thl.'pltltInl .:Iut It! n.UM •• nd vomllll'lS ... oo~tcd t:l V~ , willi ~nO'tr ehemothe"lIY'i , ' ~. If the Brli\\llr to qunl10ft a I, "Yeo', Mllh. paUe"t talllO 1(1 re.pond ~ IIQnv,"tlonlil 1""'1 V .. anllemitlOlfelitTIanti' ...., b, If ttle en~WM 10 qu;;UlIn Sa Ii "V1II5', plOU. d .. crlbo whit Iha,. traatm;nlV Wire (murJl~"Uon, G~II, ~~ , ' G. Wttll II t~@ planned ~l1dule or ohtmoltlerapYP PDU-6655-3 000417
M •••• M •• __ • ___ • __ ._·· __ •• ____ • .. •• FEB-iB-2009 14:56 From: To:360 586 0252 Praacrlbai': pie ... return thl. fQnn and the petltnt'. RalalH D'lnfOI'Matlol'l to: MocHClll OlrlO'lo1' I T hnve reviewed this vari:fiolltion fQm\~d find that usc ofmadIOlil1'nal'ijlltinaby~r, pntlCltt leI'IIlt:ItOll.,IOlo QItJ1l)t . cwlstant wlrh OOC Patill)'. .' '.' . hl.'NtlUtlttl 1.0 <strong>DOC</strong> PhVllcf.llR: Whtln fllfl'l'l I, QCf'npltll: . 1, Elman your tlndlng ,I:IOVD III Ihll Anlltlnt Secrtlla~ fQr Oommun1tv C:ClI1'~Qnll 2, Filtlhle torm and thl! aCC»1!I1JInylng ftelem or InfOtrriellon In 1.1_ n I CQmmunlty OcmIotIcna He~11h R~, PDU-6655-3000418
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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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STATE OF WASHINGTON DEPA'RTMENTOF C
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. ! STATE OF WASHINGTON DEPARTMENT
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STATE OF WASHINGTON .DEPARTMENT OF
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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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Page 409 and 410: Distefano. Monica J. (DOC) From: Se
Page 411 and 412: Distefano, Monica J. (DOC) From: Se
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Page 415 and 416: I Prescriber's Name (Print) License
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