I understand that: I am a legal medical marijuana patient and have the right to obtain and use marijuana for medicinal purposes whereby medical use has been deemed appropriate and has been recommended and/or approved by a physician licensed by the California Medical Board or the California Osteopathic Board, who has determined that my health (i.e., medical problem) would benefit from the use of medical marijuana in the treatment of my medical problems, which I represented in the medical record prior to being evaluated by my doctor whose name and info is affixed on the recommendation I am providing as proof and for my file;

I understand that: I am a qualified medical marijuana patient who is entitled to the protections provided by the California Health and Safety Code sections 11362.5 and 11262.7 as well as by Senate Bill 420 and Prop 215;

I understand that: The True and Correct copy of my most current physician’s recommendations and or approval of the use of medical marijuana is attached to this agreement;

I understand that: As a qualified medical marijuana patient and in accordance with the Compassionate Use Act and the Medical Marijuana Program Act, I intend to associate with the members of the medical marijuana collective, being hereby formed, in part, through this agreement, in order to collectively cultivate medical marijuana for medicinal purposes pursuant to the Medical Marijuana Program Act, which includes in part, California Health and Safety Code 11362.775 and section 1(b)(3) of the unmodified portion of the Medical Marijuana Program Act, which was enacted by the people of the State of California, in part, in order to promote uniform and consistent application of the Compassionate Use Act among the counties within this state, and to enhance the access of patients and caregivers to medical marijuana through collective, cooperative cultivation projects;

I understand that: As a member of this medical marijuana collective/dispensary, I understand and agree that each and every member of this collective will contribute labor, funds, supplies, services and or materials towards the cultivation and or procurement of marijuana solely for medicinal purposes;

I understand that: The collective may also provide a means for facilitating and or coordinating transactions between members, while excluding all non-members from any exchanges, reimbursements, provisions, remunerations or any other transactions that involve medical marijuana;

I understand that: None of the members of this collective shall profit from the sale or distribution of medical marijuana and that all donations provided by patients will be used to operate this collective in accordance with all State of California laws;

I understand that: Medical marijuana collectives should acquire medical marijuana only from their constituent members (i.e., patients) because only marijuana grown by a qualified patients (with a valid and current recommendation issued by a California Licensed MD or DO) or his or her primary caregiver may lawfully be transported by, or distributed to, other members of a collective or cooperative (11362.765, 11362.772);

I understand that: The collective may allocate medical marijuana to other members of the group, and that nothing allows marijuana to be distributed or allocated outside the collective and its lawful members (i.e., patients);

I understand that: Marijuana grown at a collective for medical purposes may be:<br/>

a. Provided for FREE to qualified patients and primary caregivers who are members of the collective or cooperative;<br/>
b. Provided in exchange for services rendered to the entity;<br/>
c. Allocated based on fees that are reasonable, calculated to cover overhead costs and operating expenses or;<br/>
d. Any combinations of the above;<br/>

I understand that: In accordance with the Medical Marijuana Program Act, the Compassionate Use Act, and the 208 California Attorney General Guidelines for the Security and Non Diversion of Medical Marijuana Grown for Medical Use this collective is formed in accordance with California health and Safety Code 11362.775, as well as under any and all California Health and Safety Code 11362.775 provides as follows:<br/>

a. I understand that: Qualified patients, persons with valid California Identification Card/CDL, and the designated primary caregivers of qualified patients and persons with California Identification Cards, who associate within the State of California in order to collectively or cooperatively cultivate marijuana for medical purposes, shall not solely on the basis of the fact be subject to State Criminal Sanctions under Sections: 11357, 11358, 11359, 11360, 11366, 11366.5, 115570 (H&S 11362.775);

I understand that: According to the State of California Guidelines codified within the Medical Marijuana Program and H & S Code 11362.77:<br/>

a. A qualified patient or primary caregiver may possess no more than 8 ounces (i.e., Eight Ounces) of dried medical marijuana per qualified patient;<br/>
b. Additionally, a qualified patient or primary caregiver may also maintain no more than 6 mature plants (i.e., Six Mature Plans) or 12 immature plans (i.e., Twelve Immature Plans) of medical marijuana per qualified patient;<br/>
c. If a qualified patient or primary caregiver has a physician’s recommendation that specifically indicates medical marijuana quantities that are greater than those described above, then the qualified patient and or primary caregiver may possess the amount of medical marijuana which is consistent with the quantities indicated by the California Licensed Physician;<br/>
d. Only the dried mature possessed flowers of female cannabis plant(s) or the plan conversion shall be considered when determining the allowable quantities of medical marijuana under this section;<br/>

I understand that: The Medicine Woman collectively cultivates medical marijuana for all members/patients. The Medicine Woman , agrees to possess and or cultivate enough medical marijuana to meet the aggregate of the needs of all qualified medical marijuana patients/members;

I understand that: I agree NOT to divert, furnish, sell, distribute and or give any medical marijuana to any persons who are NOT qualified patients and members of this collective (i.e., The Medicine Woman);

I understand that: When requested of me by the collective, I agree to provide any services, labor and or resources needed to maintain this collective, of which I am legally and physically able to provide;

I understand that: As a qualified medical marijuana patient whose rights are protected by California Law, Health and Safety Code 11362.5 and 11362.7, et seq., in conjunction with California Senate Bill 420 and Proposition 215, you are required to read and agree to the following statements to become a member of The Medicine Woman Please understand that this is for your own protection as well as ours.

I understand that I hereby declare that I am a qualified medical marijuana patients under California Health and Safety Code 11362.5 and 11362.7 et seq., and that my doctor has evaluated my medical problems and subsequently recommended and approved my use of medical marijuana for relief from my medical problems;

I understand that as per California Safety Code 11362.51, as a legal medical marijuana patient I can legally use and possess and cultivate cannabis for medical purposes in accordance with the terms stated above in this agreement;

I understand that I am allowed to do so through safe and affordable access such as the type provided by The Medicine Woman, therefore, I designate The Medicine Woman as my primary care provider for this purpose. In doing so, I agree to sign and follow any and all The Medicine Woman, rules and regulations regarding the services provided by this collective;

I understand that I hereby declare under penalty of perjury laws of the State of California that I am at least 18 years old and am a legal medical marijuana patient who was evaluated by a California licensed medical doctor who recommended and approved my use of medical marijuana in accordance with California State Laws and that I have been diagnosed for a serious illness(s) for which cannabis provides substantial relief;

I understand that a LEGAL medical marijuana patient means that I have a current medical marijuana recommendation issued by a California licensed physician and that the medical license of my physician is also renewed and current;

I understand that If my recommendation is revoked or expired and or my doctors State of California medical license is suspended, revoked or expired, that I am no longer a legal medical marijuana patient and will have to provide a replacement medical marijuana recommendation issued by a California license physician whose license is also RENEWED and CURRENT;

I understand that I hereby verify that I am a California resident and my personal medical marijuana will not be taken out of the State of California and I further verify and agree that the medical marijuana that I obtain will NOT be shared, sold, bartered, traded, exchanged and or delivered/used for any other purposes other than personal use;

I understand that I hereby declare that I understand the my contributions to The Medicine Woman for and through prescribed medicinal products I may require fromThe Medicine Woman are used to ensure the continued operation ofThe Medicine Woman, and that any set transaction in no way constituted any commercial promotion or sale of any item;

I understand that as a member of The Medicine Woman, I hereby agree, appoint and designateThe Medicine Woman, and their representatives as my true and correct lawful agents for the limited purpose of assisting me in obtaining medical marijuana legal recommended by my California Licensed physician whose name and info appears on my current and valid recommendation;

I understand that I hereby authorize The Medicine Woman to use the medical and physician information that I have provided to verify the validity and status of my medical recommendation from time to time. I understand that I may revoke this authorization in writing any time, which will cause my membership status to be suspended until further notice. I understand that all of the information that I am providing herein is protected by HIPAA Rules and Regulations as well as Patient Privacy Laws;

I understand that this means that The Medicine Woman, will be required to purchase, possess, transport and distribute my medication to me as recommended by my California licensed physician and I grant The Medicine Woman, the limited authority to do so;

I understand that I further authorize The Medicine Woman to share their caregiver status of my person in order to enter into contracts to obtain and or allow growth and preparation of my medication and edibles containing medical marijuana;

I understand that as a member, The Medicine Woman, has other members with similar membership agreements. I hereby authorize The Medicine Woman, to jointly possess the medical marijuana described under this agreement jointly with other members under similar membership agreements. I agree that the medical marijuana possessed by any time is the collective property of every patient who is also under this membership agreement and under the care of The Medicine Woman;

I understand that I agree to always maintain a VALID/CURRENT PHYSICIANS RECOMMENDATION and to provide The Medicine Woman, with the most current recommendation that I have been issued by my physician;

I understand that I agree and understand that if my recommendation is expired, void, revoked, etc., you will be denied access to obtain medication fromThe Medicine Woman, until such that where I have resolved and provided a valid and current recommendation to The Medicine Woman;

I understand that I agree to provide The Medicine Woman, with accurate and current personal contact info and further agree to immediately provide and update and changes made to my medical condition(s), address, contact phone number, name, recommendation status, physician contact info and license status, etc., upon any changes that occur from those representations of contact information made in this agreement;

I understand that I understand that this agreement is valid only during the time that I maintain an ACTIVE and CURRENT medical marijuana recommendation and agree to provide the most current recommendation to reflect the fact that I am a legal medical marijuana patient.

I understand that any member of law enforcement who is a bona fide patient must disclose the fact that he/she is a member of law enforcement. Otherwise, by signing these terms and conditions, I promise, state, and affirm, under penalty of perjury under the laws of the State of California, that I am not a member of, affiliated with, nor employed by any law enforcement department, entity, or agency.

 

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