Physician Recommendation


Health and Safety Code 11362.5 
PHYSICIAN’S RECOMMENDATION

This certifies that is a patient under my medical care and supervision for the treatment of  

I have discussed the medical benefits and risks of cannabis use with the patient as a treatment for these and/or other medical conditions. I recommend cannabis use for my patient.

If my patient chooses to use cannabis therapeutically, I will continue to monitor his/her medical condition and to provide advice on his/her progress.

I understand that I may be contacted to verify the information in this letter. My patient authorizes me to discuss their medical condition and the contents of this letter, for verification purposes only. I am a physician licensed to practice medicine in the state of California.

Physician’s Name (print):
Physician’s Address (Street, City, Zip Code):
Physician’s phone number:
Physician’s CA License No.:
Date: January 24, 2021

Leave this empty:

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Document name: Physician Recommendation
lock iconUnique Document ID: e728dd5d4b7f1148b770bfe6b78c2dab1b0303b2
TimestampAudit
December 30, 2020 12:47 pm PSTPhysician Recommendation Uploaded by David Coennen - customerservice@farmacann.com IP 73.66.191.127, 207.246.240.97