Medical Marijuana Program Documentation of Patient's Medical Records (California)

Form Template

If the Medical Marijuana Program Documentation of Patient's Medical Records (California) mobile app is used, this form will serve as written documentation from the attending physician, stating that the patient has been diagnosed with a serious medical condition and that the medical use of marijuana is appropriate.

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Language: English
Country: United States of America

A copy of this form must be filed in the attending physician’s medical records for the patient. If the patient chooses to apply for a Medical Marijuana Identification card through the county health department or its designee, the agency will call the attending physician to verify the information contained on this form, in accordance with Health & Safety Code, Section11362.72 (a)(3). Use canvas to populate a Value List ( Drop-Down).

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