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The purpose of this medical document is to identify the individual indicated above as a patient whose possession and/or cultivation of medical cannabis is permissible pursuant to California Health and Safety Code Section 11362.5, Compassionate Use Act of 1996 (i.e., Prop 215) and Senate Bill 420. This document affirms the fact that the patient whose name is indicated above has undergone an examination and evaluation whereby the physician, who is licensed to practice medicine in the State of California and whose name and license number are indicated below recommends that the above mentioned patient qualifies for the use of cannabis for medical purposes under California Health and Safety Code Section 11362.5, Compassionate Use Act of 1996 (i.e., Prop 215) and Senate Bill 420. The physician acts only as a consultant and not a primary care provider. The patient affirms the fact that the potential medical benefits and risks of cannabis use were discussed during the evaluation. The patient further affirms the fact that they have been informed not to drive, operate heavy machinery or engage in any activity that requires alertness while using medical marijuana. The patient assumes full responsibility for any and all risks associated with this treatment option.