FOR INDIVIDUALS WHO ARE PENNSYLVANIA RESIDENTS AGE 18 AND OLDER
IF YOU ARE UNDER 18, PLEASE STOP HERE.
• Payment for the consultation with Dr. Sam is due at the time of the scheduled consultation.
• Some employers may ask for proof that you can work safely when using medical marijuana. We can acknowledge that you are certified but cannot give a time frame for them on how long the THC will remain in your system or what effect it will have on impairement (just as we cannot commment on how long a medication like ativan or xanax (benzodiazepines) can impair you).
• WHEN COMPLETING THE FORM, YOU WILL NEED TO FILL IN EACH FIELD MARKED BY AN ASTERISK *. Your submission is completed if a screen pops up after submission stating "THANK YOU FOR YOUR SUBMISSION" with a GREEN CHECK MARK.