Liability Waiver and Release

In consideration of the medical evaluation of me to be performed by or on behalf of CannaHealrx I, my heirs, assigns and anyone acting on my behalf, agree to hold the CannaHealrx Physicians, and their principals, agents, officers, directors and employees, free and harmless from any and all claims, damages and causes of action relating to or arising out of: (1) my use or possession of cannabis (marijuana), or (2) the denial of my application for a medical cannabis card for any reason.

I understand and acknowledge that:

  1. It is my responsibility to be informed regarding State and Federal laws regarding the possession, use, sale/purchase and/or distribution of marijuana.
  2. CannaHealrx is not a Dispensary and cannot provide me with medicinal marijuana or any other medication.
  3. An evaluation that results in a physician’s recommendation that I may benefit from the use of medicinal marijuana does not guarantee that I will in fact be eligible to obtain, possess or use medicinal marijuana pursuant to your states law.
  4. A physician’s recommendation that I may benefit from the use of medicinal cannabis does not guarantee that the use of medicinal cannabis will be effective at alleviating my pain, or any other medical condition.
  5. I acknowledge that my employer or occupation may prohibit me from the use of medical marijuana even though I have state certification.
  6. Should an approval be made for my medicinal use of medical marijuana, there is a renewal date specified by the state. It is my responsibility to see the physician to assess the possible continuance of medical cannabis use beyond the term of the approval.
  7. I am at least 18 years of age and have not misrepresented any information to CannaHealrx. If I am under 18 years of age, I must have parental consent and authorization for the use of medical cannabis.
  8. I acknowledge that I am not recording any portion of my visit with CannaHealrx. I understand that CannaHealrx does not allow any recordings. Any such action is a direct violation of HIPAA regulations and patient/doctor confidentiality.
  9. I acknowledge that marijuana, even if used for medical purposes, is illegal under Federal law.
  10. I acknowledge that the use of medical cannabis products can affect coordination, motor skills and cognition, i.e., the ability to think, judge and reason. While using cannabis I should not drive, operate heavy machinery, or engage in any activities that require me to be alert and/ or respond quickly. I understand that if I drive while under the influence of medical cannabis, I can be arrested for “driving under the influence”.
  11. I understand that using cannabis while under the influence of alcohol is not recommended. Additional side effects may become present when using both alcohol and cannabis.