Sample Forms and Consents

Louisiana requires consent for a physician to prescribe medical marijuana. This formal process involves the physician explaining information regarding cannabis. The following serves as a guide for outlining information on medical marijuana related to the diagnosis being treated.

  • Policy Templates

    Policy Templates

    Sample Caregiver Acknowledgement

    Sample language to develop an acknowledgment for the caregivers of patients who use TM while admitted to the organization. This language serves as an understanding between the caregiver and the organization that the administration of TM will be conducted appropriately and according to Louisiana law.

    TAGS: language, caregiver, TM, Administration, understanding, Law

  • Policy Templates

    Policy Templates

    Sample Therapeutic Marijuana Patient Consent

    Sample patient consent to treatment with TM. This policy is most applicable to the physician office practice where the physician has been approved by LSBME to recommend TM. This language can be customized for your organization. The policy outlines side effects, risks and other important information regarding the medication.

    TAGS: LSBME, TM, Physician, Practice, language, Risk, side effect, Medication