Medical Cannabinoids Informed Consent Form

Medical Cannabinoids Informed Consent Form
What is Medical Cannabinoid?
Cannabinoids are substances found in the buds or flowers of a Cannabis plant, otherwise called as Marijuana. This is a regulated substance which is believed that when people ingest or inhale cannabis, cannabinoids are the ones giving the effects.
There have been early studies for the benefits and potential harms of cannabinoids. Thus, the intake of this substance is regulated by authorities, or in some countries, prohibited.
Risks
Potential harms exist in using cannabinoids. This document intends to outline the considerations for you to understand the risks and benefits of this substance. Having this put into consideration, your physician may consider whether this method of therapy is suitable for you.
During this time, cannabinoids should be viewed as a trial for treatment. Thus, if the intended goal for the treatment using cannabinoids is not realized, the usage of the substance should be stopped.
The following are some of the recognized risks for use of this substance:
1. Psychiatric Disturbance, including but not limited to the development of schizophrenia
2. Numbness
3. Speech disorders
4. Muscle disorders
5. Drowsiness
6. Cognitive and Memory Impairment
7. Short term memory
Benefits
The following are alleged to be the efficacy of marijuana to treat the qualifying conditions but still require further study. Caveat: there is not much literature for study or very little evidence on these areas that cannabinoids are the cure to these illnesses:
1. Cancer
2. Chronic benign pain
3. Crohn's disease
4. Epilepsy
5. Glaucoma
6. Acquired immune deficiency syndrome
7. Post-traumatic stress disorder
8. Amyotrophic lateral sclerosis
9. Multiple sclerosis
10. Parkinson's disease
Laws and Regulations
There are laws and regulations regarding the use of cannabinoids that your practitioner has to adhere to. The following requests are considered standard best practice and help this healthcare practice and you comply
with these laws and regulations.
Acknowledgment
In consideration of being allowed to consume Medical Cannabinoid, I hereby agree that during the period that I am experiencing the side effects of such use, I will not drive any vehicle or operate any heavy machinery within 8 hours.
I understand that the intake of alcohol is not recommended and dangerous and therefore I shall not take both together.
I agree to comply with the requirements set forth by the physician and shall not use marijuana in an unregulated manner. I likewise agree to use marijuana only as prescribed by my physician.
I agree not to give, sell, or share the marijuana with anyone else.
I agree to store the marijuana in my possession safely, properly, and away from the view of anyone, including children.
I shall not take the marijuana outside the country, nor should I bring it with me for travel to any other country or state.
I understand that if in any case my condition worsens or unusual or unknown side effects happen, I shall notify my physician immediately.
Age of Consent
I hereby declare that I am at least 18 years of age and diagnosed with a condition considered to be treated by the use of medical marijuana.I hereby declare that I am under 18, has a diagnosed of a condition that is considered to undergo medical marijuana treatment.
Informed Consent
I hereby declare that I have been informed of the risks and benefits as the information described above. I understand that this treatment does not guarantee positive results to treat my condition.
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Name of Parent
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