Wow thanks for the valuable link!
Do I have to file any paperwork to become a Primary Caregiver?
Edit: attached is some paperwork I wrote up tonight after examining both Prop 215 and SB420.
Please review and comment on if you think these forms afford me enough protection!
[FONT="]Qualified Patient Registration Form[/FONT]
[FONT="]xxxxxxx(name)xxxxxxxxxxxx xxxxxxxxxxxxxxxxxx(address)xxxxxxxxxx[/FONT]
[FONT="]___ Patient ___ Caregiver [/FONT]
[FONT="]First Name: __________________ Middle: __________________ Last: __________________[/FONT]
[FONT="]CA Drivers License #: _________ CA Medical Card #: _________ Prescription #: __________ [/FONT]
[FONT="]Address: _____________________________________________________________________ [/FONT]
[FONT="]City: _______________________ State: _________ Zip: _________ [/FONT]
[FONT="]Phone Number: ________________________ Email Address: ________________________ [/FONT]
[FONT="]Doctor Name: _______________________________________________ [/FONT]
[FONT="]Doctor Address: ______________________________________________ [/FONT]
[FONT="]City: _______________________ State: _________ Zip: _________ [/FONT]
[FONT="]Doctor Phone: ___________________ Doctor Fax: _______________ [/FONT]
[FONT="]Last Visit Date: ______________ Recommendation Expires: ______________ [/FONT]
[FONT="]I hereby authorize my treating doctor to release medical information regarding my diagnosis and condition to xxxxxxxxx.[/FONT]
[FONT="]Signed: ______________________________ Date: ____________________________[/FONT]
[FONT="]I understand and agree as follows:[/FONT]
[FONT="]I am a qualified patient protected by California Health and Safety Code 11362.7. et. seg., and Senate Bill 420. My doctor has recommended the use of medical marijuana and provided written documentation of such recommendation. My doctor will review my case on a yearly basis. Per the relevant sections of California law, I am able to legally possess, use, and cultivate cannabis collectively for medical purposes. I designate xxxxxxxxx as my care provider and affirm he has consistently assumed responsibility for my housing, health, or safety. I agree to follow all the rules and guidelines of my caregiver and pay reasonable compensation and/or volunteer for other services and activities provided by my caregiver as afforded under SB 420.[/FONT]
[FONT="] Signed: _____________________________ Date: ________________________________[/FONT]
[FONT="]For Caregiver Use Only[/FONT]
[FONT="]Date and Time Verified: ___________________ Verified by: __________________________[/FONT]
[FONT="]Not Verified Date: _______________ By: __________________________________[/FONT]
[FONT="]Notes: ______________________________________________________________________________[/FONT]
[FONT="]______________________________________________________________________________[/FONT]
[FONT="]______________________________________________________________________________[/FONT]
[FONT="]______________________________________________________________________________[/FONT]
_____________________________________________________________________________________
xxxxxxxxxxxx’ Patient Code of Conduct
I am grateful that my neighborhood accepts us and welcomes us. It is important that my neighbors respect us and that we respect them. Therefore, I ask your cooperation to keep us in good standing and repute.
You must be at least 18 years old with a valid California Drivers License or valid California ID in order to enter my premises. Please have your ID available for presentation at the door.
You must have a currently valid doctor's recommendation for medical marijuana. Recommendations must be renewed on a yearly basis.
Do not use or consume medicine on the premises, in the parking area, or in the surrounding neighborhood.
No active cell phones or cameras are allowed on the premises.
Please do not ask for any information other than available appointment hours over the phone. If you have questions, please ask them in person at the premises.
You may not sell or redistribute your medicine to others. Suspicious activities will be reported to law enforcement. We are here to provide medical relief to qualified patients only.
Please be very discrete. Please place your medicine out of sight before leaving my premises. Do not display or discuss your medicine in the surrounding neighborhood.
Do not engage in loud, boisterous, or disruptive behavior on or near the premises.
Do not loiter near the premises.
Use of marijuana while driving may result in charges of driving under the influence. Do not drive or operate heavy machinery while using marijuana.
Respect and show courtesy towards your Caregiver, anyone on Caregiver’s premises, and our neighbors.
I agree to these rules and I understand that violations of these rules will result in immediate termination of my status as a patient from my caregiver (xxxxxxxxxxxxxxxxxxx).
Signed: _________________________ Date: _____________________
DISCLAIMER - GENERAL RELEASE, INDEMNIFICATION AND HOLD HARMLESS CLAUSE
I _________________ being of lawful age and sound mind, do now release, acquit, and forever discharge xxxxxxxxxx, herein referred to as Caregiver, from all actions, claims, demands, or damages accruing to me from any known or unknown injury, loss, or damage sustained by or to me. This release shall remain in force and run concurrently as long as xxxxxxxxxxxxxxx remains my care provider. In witness whereof, I have executed this release in Redding, CA. I further agree to indemnify and hold harmless Caregiver from any injuries or damages resulting from use or misuse of medical marijuana obtained from Caregiver.
Signed: _____________________________ Date: _______________________________