Arizona issues a medical marijuana registry card only with a written certification on this department-provided form. The physician checks the debilitating condition under A.R.S. 36-2801, initials attestations covering the diagnosis, the medical record, a recent exam, record and PMP review, risk counseling, PTSD treatment, dispensary relationships and pregnancy risks, then attests the patient is likely to benefit.
An Arizona-licensed MD, DO, naturopathic physician (NMD/ND) or homeopathic physician (MD(H) or DO(H)) completes and signs the whole form, entering their license number and type.
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Medical Marijuana Physician Certification
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An Arizona-licensed MD, DO, naturopathic physician (NMD/ND) or homeopathic physician (MD(H) or DO(H)). The certification must be on the department-provided form, and the physician must have made or confirmed the diagnosis and maintain the patient's medical record as required by A.R.S. 12-2297.
Attestation 3 requires a physical examination within the last 90 calendar days, appropriate to the patient's presenting symptoms and the debilitating condition the physician diagnosed or confirmed. The physician enters the exam date and initials the item.
AIDS, HIV, ALS, Crohn's disease, agitation of Alzheimer's disease, cancer, glaucoma, hepatitis C and PTSD, plus a chronic or debilitating disease or its treatment causing cachexia or wasting, severe and chronic pain, severe nausea, seizures, or severe or persistent muscle spasms. For those symptoms, the underlying disease must be written in.