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'NOV-12-2008 WED 01: 45 PM 08/~4/2ooa 2Q:45 FAX 509340.2710 , SPOMNE NBS UN I T FAX No. 509-482-385'3 p. 005 laI OO$/ooa Prascrlber: please return this for~ and the patient's Release of Information to: Medical Director ,Heruth SerVices Division Washington State Department ofCo1l'ectioos ~O Box 41123 Olympia, WA 98504-2113 To be fllled out by <strong>DOC</strong> Phy~lcl~/1: 1 have reviewed this verification raztfi and find that use of medical marijuana by this pattent , a (dI~cI< cna) lOis IMfs not ~/ ' con~tent ~th <strong>DOC</strong> ~Olicy., ' ' " ' .,SteVb\ HuiAAvv,.~l.~l> ,hJ~ Physician's Name (Print) pny5Iclan'~ Slgl'lllMe Inatrl,lr;tjonG to tlOC Physlg!an: , . When form Is oomplete: 1. Email your finding above to the Assistant Slicratary for Community Correc~onB 2. Fi!e this form and the accompanyIng Release of Information in Liberty as a Community Corrections Health Record. " . ,slatdaw (ReW 70. 1}2: RCW 10.2
j " 'NO~:12-2008 WEO 01:44 Pi SPOKANE NBS UN[T. FAX No. 509-482-3853 p. 001 I DEPARTMENT OF CORRECTIONS, . . OFFICE OF CORRECTIONAL OPERATIONS'. :NBS UNJT/NORTH NEVA~Woob COPS 4705 N. ADDI$ON', SPOKANE .WA 99207 .. FAX (509) 482-3853 : , . ! FROM: TO: S+evp- " FAX: (3,,0) =:' .. ~ Jack Brucick D . Lynda Douglas o Kira Bliss H~ (509) 482-385~ (509) .482-3856 (509) 482-3857 W=:f761 . PHONE: '(3 ,,~ . 7~S - g 761 - 70&'1)' . TOTAL NO. OF PAGES INCLUD[NG COVER: ~ '. /0 o Per your re~uest Confidentiality, Notice .' , This facsimile tran~missian, a,nd any·document(s) accompanying it, may contain confidential information belongir:tg to the sender, and which may, in part or whole" be protected. by Title 18, United States Code, Section 3153(c)(1) . and, Pretrial Confidentiality Regulations. Thi~ information is'intend'ed solely for the use of the Indiviaual or entity named above, If you are. not the intended recipient, you are hereby notified that any disclosure, copying, , distribu!iolJ, or the taking of any action in reliance upon the contents of.this infonnation is prohibited. If you have received this transmission in error! contact our off/ye by phone ImmediatelY: to arrange for the return of the document(s) transmitted. Thank you for your fulf'cooperation {n thi~·matter. PDU:.6655-3 000430·
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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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311S'E. Mission Ave Spokane, WA 992
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j I Documentation of MedicarAuthcir
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Chapter 69.51 A RCW: Medical marij1
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Chapter 69.S1A RCW: Medical marijua
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Chapter 69.511). RCW: Medical111ari
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OFFENDER 1.0. DATA: STATE OF WASHIN
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3115 E. Mission Ave Spokane, WA 992
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. ! STATE OF WASHINGTON DEPARTMENT
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STATE OF WASHINGTON .DEPARTMENT OF
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T.)' ~x.. MARIJUANA MEDICINE'· 'EV
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Wheeler, Judine L. (DOC) From: Sent
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Prescdbar's Name (pnnt) . Prasc~jje
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I I do ncit want to ruffle feathers
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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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Distefano, Monica J; (DOC) From: Se
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3. High Non-Violent 4. Moderate, an
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, ' ~. With Community Corrections S
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I FW: 380200 Community Supervision
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E.... KIOSK reporting may be used i
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to be processed now. If this was re
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Stern, Marc F. 'Dir Hlth Svc' (~OC)
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I J i Date License type: Prescriber
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J STATE OF WASHINGTON DEPARTMENT OF
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Page 391 and 392: Distefano, Monica J. (DOC) From: Ha
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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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DOC request three complete - Cannabis Defense Coalition

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