Registered Caregiver Information (if applicable)
(A Registered Caregiver is a person chosen by the patient to act as their agent in obtaining their medication at the dispensary. If you feel that you need a caregiver, please contact your certifying physician.)
I understand that it is unlawful to use and possess medical marijuana outside of the State of Massachusetts. I understand that my registration card does not allow me to cultivate marijuana for any purpose unless I have applied for and received a Hardship Cultivation License.
I agree that I will not divert any marijuana to any other person. All medical marijuana I purchase will be for my sole consumption. I agree that I will bring any unwanted or unconsumed marijuana to a Registered Marijuana Dispensary for disposal.
I acknowledge that I have received the Mayflower Medicinals Patient Guide.
It has been discussed with me that marijuana has not been analyzed or approved by the FDA and that medical cannabis may contain unknown quantities of active ingredients, impurities or contaminants.
The efficacy and potency of cannabis may vary widely depending on the cannabis strain and ingestion method.
Marijuana consumption during pregnancy and breastfeeding may pose potential harms.
Driving under the influence of Marijuana is prohibited by M.G.L c. 90, s. 24, and machinery should not be operated
I agree to not bring a weapon, or anything that can be used as a weapon to a Mayflower Medicinals facility.
I agree to abide by Massachusetts Law in regard to my use of medical marijuana, and hereby release and waive all claims against Mayflower Medicinals from any and all liability related to my use of medical marijuana.
Please do not sign this agreement if you do not understand the information you have received or not comfortable with the risks that may be related to cannabis use or possession.