DOC request three complete - Cannabis Defense Coalition

OCT/ Oct. B. LUO~, 11: ::J9AM T ~co tt l. Havsy, UU, .U·AA~MF.AX· No. 1253597("""O:::.~ .. No. 1L1~ ~. L
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• ~l STATE OF WASHINGTON
II lUI'. DfPAR1'M!NTOFeORRECTIONS
Me~lelnal Use of MarfJuana Verification
Dear Prescriber... '. .'
. By state statute the Washington State Department of Corrections is charged with the responsibility to supervise some.
offenders after they have been eonvlct~ Of' a f~lony. The above named .. patient il currently under supervision by the
Department Supervision is delalgned to help the offender aVQid those environments or.sltuaUons that lead to their criminal
behavior. Often illicit drug use Is a confribu,ting fac!or in an individual's criminality. Accordingly !tiS usual that the court or
·the Departmen~ of CorrectIons wllllmpo.se a tondrtlon of supervision that the offender not ulle, or possess Dlicit drugs, .
r including marijuana. This offender has claimed· that tl1ey have a. condition for which the m$dlelnal use of marijuana has
been recommended. The below verification is to determine !he legitimacy of their claim. Thank you. il) advance for your
assIstance. If you have questions please. fee! free to pemonally tomact the Medical Director of the Department at (360)
725-8700: . . . .... . . . .
. . ~
'1. Is this patient under YD':!r care .
2.
Are you recommending medical marijuana for his patient due to a diagnosis of Acqujred
.. Immunodeficiency Syndrome (AIOS) . . . .
B.
b.
If the answer to question 2ls "Yes·, does he/she have anorexia
if the answer. to quest/on 2a Is "Yes~, dQeshe/she have weight loss
3 ...·Ara you recommending medical marijuana for this patient due to nausea "and vomiting
.as~ociated with cancer chemotherapy . .
4.
a..
If' the answer to qfJestion 3 Is "Yes·, has the patient failed to respond to conventlonel
antiemetic Iraatmente
DVes
DVes ONo
DYes DNO
DYes ~
DYes
b. .If the answer to question Sa is 'Yes--, please describe what those treatments were (medicatlon. dos~, ..
duration):
DNa'
~ What~~,~neJi:W~~=IJIJt-~ .~~
If you ans/;f;;;.NO" to It~£ 2 8. 3 above, what,is the reason you are recommendIng medicinal use Of ..
marijUa~ " .'. 'I-~ . ~~. /1.~c- 12,/1. . . fiJ~
j}tYl It- 1 ~ ~~v') :
•. Please Pro,1de sv'