• AZDHS Physician FAQ’s

    AZDHS Physician FAQ’s

    For Physicians:

    The law and rules specify requirements for issuing written certifications for patients for the medical use of marijuana. A physician is required to:

    • Have made or confirmed a diagnosis of a debilitating medical condition, as defined in A.R.S. § 36-2801, for the qualifying patient; Have established a medical record for the qualifying patient and am maintaining the qualifying patient’s medical record as required in A.R.S. § 12-2297;
    • Have conducted an in-person physical examination of the qualifying patient within the last 90 calendar days appropriate to the qualifying patient’s presenting symptoms and the debilitating medical condition the physician diagnosed or confirmed;
    • Have reviewed the qualifying patient’s medical records, including medical records from other treating physicians from the previous 12 months, the qualifying patient’s responses to conventional medications and medical therapies, and the qualifying patient’s profile on the Arizona Board of Pharmacy Controlled Substances Prescription Monitoring Program database;
    • Have explained the potential risks and benefits of the medical use of marijuana to the qualifying patient, or if applicable, the qualifying patient’s custodial parent or legal guardian;
    • If the physician has referred the qualifying patient to a dispensary, have disclosed to the qualifying patient, or if applicable, the qualifying patient’s custodial parent or legal guardian, any personal or professional relationship I have with the dispensary; and
    • Attest that, in the physician’s professional opinion, the qualifying patient is likely to receive therapeutic or palliative benefit from the qualifying patient’s medical use of marijuana to treat or alleviate the qualifying patient’s debilitating medical condition.

    In addition, for a patient who is under the age of 18, another physician must:

    • Have conducted an comprehensive review of the qualifying patient’s medical records from other physicians treating the qualifying patient;
    • If the physician has referred the qualifying patient to a dispensary, have disclosed to the qualifying patient, or if applicable, the qualifying patient’s custodial parent or legal guardian, any personal or professional relationship I have with the dispensary; and
    • Attest that, in the physician’s professional opinion, the qualifying patient is likely to receive therapeutic or palliative benefit from the qualifying patient’s medical use of marijuana to treat or alleviate the qualifying patient’s debilitating medical condition

    ADHS will periodically review the demographics of qualifying patients. If ADHS determines that a physician providing written certifications may be engaging in unprofessional conduct, ADHS will provide information to the physician’s licensing board..

    The duties of a dispensary’s medical director include providing guidance to staff and clients of the dispensary. A medical director is not permitted by the rules to provide written certifications for medical marijuana.

    The fees are listed in rules and include:

    • $150 for an initial or a renewal registry identification card for a qualifying patient. Some qualifying patients may be eligible to pay $75 for initial and renewal cards if they currently participate in the Supplemental Nutrition Assistance Program.
    • $200 for an initial or a renewal registry identification card for a designated caregiver. A caregiver must apply for a new card for every patient under their care (up to five patients).
    • $500 for an initial or a renewal registry identification card for a dispensary agent.
    • $5,000 for an initial dispensary registration certificate.
    • $1,000 for a renewal dispensary registration certificate.
    • $2,500 to change the location of a dispensary or cultivation facility.
    • $10 to amend, change, or replace a registry identification card.

    A physician may notify the Department if:

    • the patient no longer has a debilitating medical condition; or
    • the physician no longer believes that the qualifying patient receives therapeutic or palliative benefit from the medical use of marijuana; or
    • the physician believes that the qualifying patient is not using the medical marijuana as recommended.

    When the Department receives this notification from the physician who provided the written certification, the Department will notify the patient that the patient’s registry identification card is void (R9-17-109) and no longer valid.

    For a patient diagnosed with a debilitating medical condition listed on the certification form, a physician is only required to mark that condition. If the physician marks a box in the second set of choices (cachexia or wasting syndrome; severe and chronic pain; severe nausea; seizures, including those characteristic of epilepsy; or severe or persistent muscle spasms, including those characteristic of multiple sclerosis) indicating a symptom caused by a condition or treatment, the physician must also write the name of the underlying chronic or debilitating disease or medical condition.

    36-2801. Definitions

    (Caution: 1998 Prop. 105 applies)

    In this chapter, unless the context otherwise requires:

    1. “Allowable amount of marijuana”

    (a) With respect to a qualifying patient, the “allowable amount of marijuana” means:

    (i) Two-and-one-half ounces of usable marijuana; and

    (ii) If the qualifying patient’s registry identification card states that the qualifying patient is authorized to cultivate marijuana, twelve marijuana plants contained in an enclosed, locked facility except that the plants are not required to be in an enclosed, locked facility if the plants are being transported because the qualifying patient is moving.

    (b) With respect to a designated caregiver, the “allowable amount of marijuana” for each patient assisted by the designated caregiver under this chapter means:

    (i) Two-and-one-half ounces of usable marijuana; and

    (ii) If the designated caregiver’s registry identification card provides that the designated caregiver is authorized to cultivate marijuana, twelve marijuana plants contained in an enclosed, locked facility except that the plants are not required to be in an enclosed, locked facility if the plants are being transported because the designated caregiver is moving.

    (c) Marijuana that is incidental to medical use, but is not usable marijuana as defined in this chapter, shall not be counted toward a qualifying patient’s or designated caregiver’s allowable amount of marijuana.

    2. “Cardholder” means a qualifying patient, a designated caregiver or a nonprofit medical marijuana dispensary agent who has been issued and possesses a valid registry identification card.

    3. “Debilitating medical condition” means one or more of the following:

    (a) Cancer, glaucoma, positive status for human immunodeficiency virus, acquired immune deficiency syndrome, hepatitis C, amyotrophic lateral sclerosis, crohn’s disease, agitation of alzheimer’s disease or the treatment of these conditions.

    (b) A chronic or debilitating disease or medical condition or its treatment that produces one or more of the following: cachexia or wasting syndrome; severe and chronic pain; severe nausea; seizures, including those characteristic of epilepsy; or severe and persistent muscle spasms, including those characteristic of multiple sclerosis.

    (c) Any other medical condition or its treatment added by the department pursuant to section 36-2801.01.

    4. “Department” means the Arizona department of health services or its successor agency.

    5. “Designated caregiver” means a person who:

    (a) Is at least twenty-one years of age.

    (b) Has agreed to assist with a patient’s medical use of marijuana.

    (c) Has not been convicted of an excluded felony offense.

    (d) Assists no more than five qualifying patients with the medical use of marijuana.

    (e) May receive reimbursement for actual costs incurred in assisting a registered qualifying patient’s medical use of marijuana if the registered designated caregiver is connected to the registered qualifying patient through the department’s registration process. The designated caregiver may not be paid any fee or compensation for his service as a caregiver. Payment for costs under this subdivision shall not constitute an offense under title 13, chapter 34 or under title 36, chapter 27, article 4.

    6. “Enclosed, locked facility” means a closet, room, greenhouse or other enclosed area equipped with locks or other security devices that permit access only by a cardholder.

    7. “Excluded felony offense” means:

    (a) A violent crime as defined in section 13-901.03, subsection B, that was classified as a felony in the jurisdiction where the person was convicted.

    (b) A violation of a state or federal controlled substance law that was classified as a felony in the jurisdiction where the person was convicted but does not include:

    (i) An offense for which the sentence, including any term of probation, incarceration or supervised release, was completed ten or more years earlier.

    (ii) An offense involving conduct that would be immune from arrest, prosecution or penalty under section 36-2811 except that the conduct occurred before the effective date of this chapter or was prosecuted by an authority other than the state of Arizona.

    8. “Marijuana” means all parts of any plant of the genus cannabis whether growing or not, and the seeds of such plant.

    9. “Medical use” means the acquisition, possession, cultivation, manufacture, use, administration, delivery, transfer or transportation of marijuana or paraphernalia relating to the administration of marijuana to treat or alleviate a registered qualifying patient’s debilitating medical condition or symptoms associated with the patient’s debilitating medical condition.

    10. “Nonprofit medical marijuana dispensary agent” means a principal officer, board member, employee or volunteer of a nonprofit medical marijuana dispensary who is at least twenty-one years of age and has not been convicted of an excluded felony offense.

    11. “Nonprofit medical marijuana dispensary” means a not-for-profit entity that acquires, possesses, cultivates, manufactures, delivers, transfers, transports, supplies, sells or dispenses marijuana or related supplies and educational materials to cardholders. A nonprofit medical marijuana dispensary may receive payment for all expenses incurred in its operation.

    12. “Physician” means a doctor of medicine who holds a valid and existing license to practice medicine pursuant to title 32, chapter 13 or its successor, a doctor of osteopathic medicine who holds a valid and existing license to practice osteopathic medicine pursuant to title 32, chapter 17 or its successor, a naturopathic physician who holds a valid and existing license to practice naturopathic medicine pursuant to title 32, chapter 14 or its successor or a homeopathic physician who holds a valid and existing license to practice homeopathic medicine pursuant to title 32, chapter 29 or its successor.

    13. “Qualifying patient” means a person who has been diagnosed by a physician as having a debilitating medical condition.

    14. “Registry identification card” means a document issued by the department that identifies a person as a registered qualifying patient, registered designated caregiver or a registered nonprofit medical marijuana dispensary agent.

    15. “Usable marijuana” means the dried flowers of the marijuana plant, and any mixture or preparation thereof, but does not include the seeds, stalks and roots of the plant and does not include the weight of any non-marijuana ingredients combined with marijuana and prepared for consumption as food or drink.

    16. “Verification system” means a secure, password-protected, web-based system established and maintained by the department that is available to law enforcement personnel and nonprofit medical marijuana dispensary agents on a twenty-four hour basis for verification of registry identification cards.

    17. “Visiting qualifying patient” means a person:

    (a) Who is not a resident of Arizona or who has been a resident of Arizona less than thirty days.

    (b) Who has been diagnosed with a debilitating medical condition by a person who is licensed with authority to prescribe drugs to humans in the state of the person’s residence or, in the case of a person who has been a resident of Arizona less than thirty days, the state of the person’s former residence.

    18. “Written certification” means a document dated and signed by a physician, stating that in the physician’s professional opinion the patient is likely to receive therapeutic or palliative benefit from the medical use of marijuana to treat or alleviate the patient’s debilitating medical condition or symptoms associated with the debilitating medical condition. The physician must:

    (a) Specify the qualifying patient’s debilitating medical condition in the written certification.

    (b) Sign and date the written certification only in the course of a physician-patient relationship after the physician has completed a full assessment of the qualifying patient’s medical history.

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