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THCF Medit:al Clinics 1813 130 th AV,e. NE· #210 Belle\lue, VI/A 98005 Phone: 425-869-6186 or 800-723-0188 Fax: 425-869-6378 www.thc-foundation.org www.hemp.org., . Documentation qf Medical Authorization to Possess Marijuana.,for Medical , .. '. Purposes in Wa~hington State, ( ,,' . . The te~t of this ,~O(J1i,Wf.lS recommended by the Washington State Medical ASSQgi:~tlon, . . '. . : .;t.- .... : Patien~· Name: . Date of Birth- I I I I' I I ;. j ! I, Thomas a physician licensed in the state oniVashington. I am treating the . , above named' , a terminal illness or a'Ci"l:!pilitating condition as define~ in the RCW 69,51A.OIO. h.ave.,~L1'iiised the above named t:>atient about the potential risks .and benefits of the the medical use',oJ marijuana. I have assessed the above named patient's medical history and medical condil;i9..~. It is my medical opinion th,at the potential l:ienefits of the medical use of marijuana would lik¢l¥ outweigh the health .risks fqr this patient. ' ... ~ .. Tod~y'~ bate: 4)~be C Ol..\ db()...1L- Exp~ratlon Date: t;lec-p,'Q'"\);)( ,r" Risks and benefIts .pf medical madjuana:-t. .. , .... . ~ C)Y r.9cL:J1 Under Washington state law, the use of medical marijuana is now permissiQle for some patients' with terminal or debilitating iI!nesses. The laws re~ulation this (ReW 69.51A.) allows physician's to a.dvise patiel:l~~ ab.out the risks and benefits of t9.e medical use of marijuana.; ; The medic~! a~d':s~.i~~tjfiC evidence supporting th~. use of medical marij~ana fe;~ai.ns . controversial in the m~9.ical community, Not all, h~~lth care providers believe't1.u.at medical marijuana is safe or eflJective and some providers f!,!el that it is a dangerous drug,. . • ~ t· .. . According to the washiJ.lgton state law the benefits of medica! marijuana may glduqe treating nausea and vomitilig'l;t~m chemotherapy; AIDS wasting syndrome; severe mu~de spasms from multiple sclerosis OT otrler spastIcity disorders; glaucoma; 'and some types of in~ractable pain. !. • • • ..... 'i ~~l .:~{. .• Some o(th~ risk~::~ff.'B.~di¢a'l marijuana may inclu~~-possible long-term effe~t~ of t,he brain in the : areas of memory, ·coP'ftlination and cognition; impllirment of the ability to drive.,:or operate heavy machinery; respirC:!t9rY, damage:; possible lung cancer; physical orpsychofogical dependence·, , " " .:' ' ... , R.ECEIVED , fE~ 042009 OFFENDER COpy o.SPT Of COR~EOTrONS . SHELTON rlELD OfFICE PDU-6655-3000075
Wheeler, Judine L. (DOC) From: Sent: To: Cc: Subject: Attachments: Daniels, Karen R. (DOC) Thursday, March 19; 2009 11 :01 AM DOC DL ALL CCD STAFF , Vail, Eldon W. (DOC); Strange, Cheryl E. (DOC); Blonien, John 'Scott'; Hammond, G. Steven (DOC) CCD Medical Marijuana Process Changes Memo Medical Marijuana Process Change 031309.pdf; 14-053 Medicinal Marijuana Form 031609.doc Good moming! Please see the attached mellio which identifies changes in the current medicinal marijuana, ---Pi'(Jc-es'S:-rveaI'S,nrtt~[(:;lred-Fm'firl*05"'3-wl'Ii:(':lrWlf:rlll'dro:-ed-urr;3tt6i09-ro-:reilm:Ltl:re~h1fIIg"e-hrproc-ess. ---- In addition, I've broken down the process to give you a little guidance on timeline expectations. Please feel free to contact me army assistant, Monica Distefano, if you have any questions. Thank you! rm Medical Marljuarla 14-053 Medlclrlal Process Chan... Marijuana For ... i I 'Karen 'DanIels Assistant Secretary Community Corrections Dlvlslorl Department of Corrections 7345 Llnderson Way SoN Tumwater, WA 98504 Office: 360-725-8787 Cell: 360-791-7768 Fax: 360-586-0252 email: krdanlels@doc1.wa.gov " r 1 PDU-6655-3 000076
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