Canadian Cannabis Consulting

Canadian Cannabis Consulting -

Patient Prequalification

The regulations outline two categories of people who can apply to possess marihuana for medical purposes.


Category 1:

This category is comprised of any symptoms treated within the context of providing compassionate end-of-life care; or the symptoms associated with the specified medical conditions listed in the schedule to the Regulations, namely:

• Severe pain and/or persistent muscle spasms from multiple sclerosis;

• Severe pain and/or persistent muscle spasms from a spinal cord injury;

• Severe pain and/or persistent muscle spasms from spinal cord disease;

• Severe pain, cachexia, anorexia, weight loss, and/or severe nausea from cancer;

• Severe pain, cachexia, anorexia, weight loss, and/or severe nausea from HIV/AIDS infection;

• Severe pain from severe forms of arthritis; or

• Seizures from epilepsy.


Applicants must provide a declaration from a medical practitioner to support their application.


Category 2:

This category is for applicants who have debilitating symptom (s) of medical condition (s), other than those described in Category 1. Under Category 2, persons with debilitating symptoms can apply to obtain an Authorization to Possess dried marihuana for medical purposes, if a specialist confirms the diagnosis and that conventional treatments have failed or judged inappropriate to relieve symptoms of the medical condition. While an assessment of the applicant’s case by a specialist is required, the treating physician, whether or not a specialist, can sign the medical declaration.


If your Doctor refuses to participate we urge you to fill out Health Canada forms, everything but the B1 and B2, also send in your passport photos, you have now notified the government of your non-criminal intent. Then fill out Notice of Medical Treatment. Now you have informed your doctor of your choice.


Copy, paste and edit the following:


Notice of choice of medical treatment

Attention Doctor _______________________________________ ;

Pleased be advised that I, _______________________________; am

officially informing you of my decision to use Cannabis/Marijuana for medical reasons to treat the following ailments/symptoms:


Be advised that I use __ grams per day as required in the following forms:

1._____ grams per day inhaled (smoked or vaporized)

2._____ grams per day orally (eaten)

3._____ grams per day orally (steeped in hot water as a tea)

This notice is to give you adequate information about my choice of medication so that you may continue to treat me and my present ailments and future medical problems as safely as possible with a minimum negative interaction to present and future proposed medical treatment, and for a legal excuse to be in possession of Cannabis should the need arise until such time as I obtain federally exempted status under the MMAR .


(patient’s name, address and telephone) please print

__________________________________________(patient’s signature)

____________________________________________(witness signature and printed name)

Received by__________________________________________________

(Physician’s signature of receipt of notice and stamp) (Physician’s signature is not considered as

endorsement or recommendation or prescription for cannabis use but is only to affirm receipt of

this notice)