Documentation of Medical Authorization to Possess Marijuana for Medical Purposes in Washington State

Documentation of Medical Authorization to
Possess Marijuana for Medical Purposes in Washington State

 
Patient Name ________________________
Date of Birth ________________________

I am a physician licensed in the State of Washington. I am treating the above named patient for a terminal illness or a debilitating condition as defined in RCW 69.51A.010.

I have advised the above named patient about the potential risks and benefits of the medical use of marijuana. I have assessed the above named patient's medical history and medical condition. It is my medical opinion that the potential benefits of the medical use of marijuana would likely outweigh the health risks for this patient.

Signature of Physician: __________________________________________

Printed Name of Physician: _______________________________________
 
Risks and benefits of medical marijuana

Under Washington state law, the use of medical marijuana is now permissible for some patients with terminal or debilitating illnesses. The law regulating this (RCW 69.51A) allows physicians to advise patients about the risks and benefits of the medical use of marijuana.

The medical and scientific evidence supporting the use of medical marijuana remains controversial in the medical community. Not all health care providers believe that medical marijuana is safe or effective and some providers feel that it is a dangerous drug.

According to the Washington state law the benefits of medical marijuana may include treating nausea and vomiting from chemotherapy; AIDS wasting syndrome; severe muscle spasms from multiple sclerosis or other spasticity disorders; glaucoma; and some types of intractable pain.

Some of the risks of medical marijuana may include possible long-term effects of the brain in the areas of memory, coordination and cognition; impairment of the ability to drive or operate heavy machinery; respiratory damage; possible lung cancer; and physical or psychological dependence.
 
Text on this form provided by the Washington State Medical Association