• I understand and agree that medical cannabis received from New MexiCann Natural Medicine is for the exclusive use of the approved applicant and may not be resold or given to any person

 

  • I understand that the corporation reserves the right to refuse service to anyone whom in its opinion may be in violation on NM medical cannabis law and or NM Dept. of Health medical cannabis rules and regulations.

 

  • I agree to notify the corporation of any changes the corporation of any changes in my status in the NM DOH Medical Cannabis Program, any change in my condition for which medical cannabis is recommended, any change in my contact or delivery information and any change in my listed physicians.

 

  • I understand and agree to abide by all applicable NM medical cannabis law, rules and regulations. I warrant that all the information provided by me is true and accurate.

 

  • I understand and agree that all information provided will be treated as confidential patient medical information and not released to any party other than the NM Dept. of Health as may be required.

 

  • I understand the risk of using marijuana and agree to use it responsibly. I further fully release and indemnify New Mexican Natural Medicine from any damages resulting from my use of and/or possession of marijuana, including criminal prosecution. I also understand and take full responsibility for any health hazard that may be caused by using cannabis.

 

The Health Insurance Portability and Accountability Act (HIPAA) provides rules and regulations as to who may see or be notified of your Protected Health Information (PHI). These restrictions do not include the normal interchange of information necessary to provide you with office services. HIPAA provides certain rights and protections to you as the patient. We balance these needs with our goal of providing you with quality professional service. A complete text of your HIPAA policy is available upon request.