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DOC request three complete - Cannabis Defense Coalition

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Dec, 23, 2008 5: 32PM CBR Med i ca 1 -Inc, No,2827 p, 5/36<br />

_ Documentation of Medical Authorization to Possess Marijuana<br />

'for Medical Purposes in Washingt~m State<br />

PATIENT NAME: ~_----'<br />

DATEOFBIRTH:~<br />

I, - Antoine Johnson ' ,am a physician licensed in the State of Washington<br />

and 1 am treating the above patient for a terminal mness or a debilitating condition as defined by<br />

RCW 69.51A.01 D. -<br />

I have advised the above named patient about the potential risks and benefits of the medical use<br />

of marijuana. I have assessed the above named p.1iltient's medical history and medical condition.<br />

It is my medical opinion that the potential benef~f the medical Lise of marijuana may outweigh<br />

:the health risks for this patient. _ /,1'/ _ .<br />

Physician Name:. Dr. Antoine Joh!')ion "<br />

WA License Number: - MD00039048<br />

,/'<br />

./<br />

Physician Signature: __-..,,;...l_......;~~___ ~ Date: _ ........_121_1_4_/2-'-0-'-08 ____<br />

I . I<br />

This recommendation expires on: 121[4/2009 _<br />

Risks and-benefits of medical marijuani . . - - _.' - '-<br />

Under Washington law. the use of d,edical marijuana is now permissible for some patients<br />

with terminal or debilitating iIInesseS£he law regulating this (RCW 69.51A) allows physicians<br />

to advise patients about the risks an. benefits of the- medical use of marijuana.<br />

The medh::al and scientific evicle ' e supporting the use of mediCal marijuana remains<br />

controversial in the medic6l1 commu ity. Not all health care providers believe that medical<br />

marijuana is safe or effective lind some providers.feel that it is a dangerous drug_<br />

According to the Washington State law the benefits of medical marijuana may include<br />

treating nausea and vomiting from chemotherapy, AIDS wasting syndrome, severe mU$cle<br />

spasms froll! multiple sclerosis or other spasticity disorders, glaucoma, and some tYpes of<br />

intractable pain_ - -<br />

Some of the risles of medical marijuana may include possible long-term effects of the brain in<br />

the_ areas of memo!)" coordination and cognition; impairment of the ability to drive or operata<br />

heavy machinery; respiratory damage; possible lung cancer; and phySical or psychological<br />

dependence.<br />

Recommendation<br />

. As this patient's "60 Pay Supply",a.s stipulated by RCW 69.51A.040 (3)(b) and<br />

WAC 246·75.010, this Qualifying Patient can reasonably expect to have in their Pose$sion and<br />

-------INeed-a-total-ef-ne-mere-thaA-24-GuAGes-ef.!!l-Jseable-Mar-ijuafla!LaF\d-R0-FfI(')ra~thaA-1-§-F!laAts,s.,----~~--<br />

CBR Medical~ (nc . .<br />

Administrative Office<br />

3115 E. Mission Ave, Spokane, WA99202<br />

Spokane: 509-242·8624 Fax:509-340-2710<br />

Seattle: 205-774-5493 Fax: 205-418·6659<br />

EMERGENCY OR LAW ENFORCEMENT ONLY<br />

CALL 509·570·2886 OR 509·570·6943<br />

PDU-6655-3 000444

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