STATUTORY CITATIONS FOR MARIJUANA REGISTRY APPLICATION
Application for Registry Identification Card for Medical Use of Marijuana
AS 17.37.010(c) [FONT=Arial,Arial][FONT=Arial,Arial]In order to be placed on the state's confidential registry for the medical use of marijuana, an adult patient or a parent or guardian of a minor patient shall provide to the department
[/FONT][/FONT](1) [FONT=Arial,Arial][FONT=Arial,Arial]a statement signed by the patient's physician
[/FONT][/FONT](A) [FONT=Arial,Arial][FONT=Arial,Arial]stating that the physician personally examined the patient and that the examination took place in the context of a bona fide physician-patient relationship and setting out the date the examination occurred;
[/FONT][/FONT](B) [FONT=Arial,Arial][FONT=Arial,Arial]stating that the patient has been diagnosed with a debilitating medical condition; and
[/FONT][/FONT](C) [FONT=Arial,Arial][FONT=Arial,Arial]stating that the physician has considered other approved medications and treatments that might provide relief, that are reasonably available to the patient, and that can be tolerated by the patient, and that the physician has concluded that the patient might benefit from the medical use of marijuana;
[/FONT][/FONT](2) [FONT=Arial,Arial][FONT=Arial,Arial]a sworn application on a form provided by the department containing the following information:
[/FONT][/FONT](A) [FONT=Arial,Arial][FONT=Arial,Arial]the name, address, date of birth, and Alaska driver's license or identification card number of the patient;
[/FONT][/FONT](B) [FONT=Arial,Arial][FONT=Arial,Arial]the name, address, and telephone number of the patient's physician; and
[/FONT][/FONT](C) [FONT=Arial,Arial][FONT=Arial,Arial]the name, address, date of birth, and Alaska driver's license or identification card number of the patient's primary caregiver and alternate caregiver if either is designated at the time of application, along with the statements required under (d) of this section; and
[/FONT][/FONT](3) if the patient is a minor[FONT=Arial,Arial][FONT=Arial,Arial], a statement by the minor's parent or guardian that the patient's physician has explained the possible risks and benefits of medical use of marijuana and that the parent or guardian consents to serve as the primary caregiver for the patient and to control the acquisition, possession, dosage, and frequency of use of marijuana by the patient.
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