1. (1) The written certification provided by a physician must be made on a form prescribed by the department and signed and dated by the physician. The written certification must:

   1. (a) include the physician's name, license number, and office address and telephone number on file with the board of medical examiners and the physician's business e-mail address, if any; and
   2. (b) the name, date of birth, and debilitating medical condition of the patient for whom the physician is providing written certification.

2. (2) A treating physician or referral physician who is providing written certification for a patient shall provide a statement initialed by the physician that must:

   1. (a) confirm that the physician is:

      1. (i) the patient's treating physician and that the patient has been under the physician's ongoing medical care as part of a bona fide professional relationship with the patient; or
      2. (ii) the patient's referral physician;
   2. (b) confirm that the patient suffers from a debilitating medical condition;
   3. (c) describe the debilitating medical condition, why the condition is debilitating, and the extent to which it is debilitating;
   4. (d) confirm that the physician has assumed primary responsibility for providing management and routine care of the patient's debilitating medical condition after obtaining a comprehensive medical history and conducting a physical examination, whether in person or, in accordance with subsection (4), through the use of telemedicine, that included a personal review of any medical records maintained by other physicians and that may have included the patient's reaction and response to conventional medical therapies;
   5. (e) describe the medications, procedures, and other medical options used to treat the condition;
   6. (f) state that the medications, procedures, or other medical options have not been effective;
   7. (g) confirm that the physician has reviewed all prescription and nonprescription medications and supplements used by the patient and has considered the potential drug interaction with marijuana;
   8. (h) state that the physician has a reasonable degree of certainty that the patient's debilitating medical condition would be alleviated by the use of marijuana and that, as a result, the patient would be likely to benefit from the use of marijuana;
   9. (i) confirm that the physician has explained the potential risks and benefits of the use of marijuana to the patient;
   10. (j) list restrictions on the patient's activities due to the use of marijuana;
   11. (k) specify the time period for which the use of marijuana would be appropriate, up to a maximum of 1 year;

   12. (l) state that the physician will:

       1. (i) continue to serve as the patient's treating physician or referral physician; and
       2. (ii) monitor the patient's response to the use of marijuana and evaluate the efficacy of the treatment; and
   13. (m) contain an attestation that the information provided in the written certification and accompanying statements is true and correct.

3. (3) A physician who is the second physician recommending marijuana for use by a minor shall submit:

   1. (a) a statement initialed by the physician that the physician conducted a comprehensive review of the minor's medical records as maintained by the treating physician or referral physician;
   2. (b) a statement that in the physician's professional opinion, the potential benefits of the use of marijuana would likely outweigh the health risks for the minor; and
   3. (c) an attestation that the information provided in the written certification and accompanying statements is true and correct.

4. (4) A physician who is providing written certification through the use of telemedicine:

   1. (a) shall comply with the administrative rules adopted for telemedicine by the board of medical examiners provided for in 2-15-1731; and
   2. (b) may not use an audio-only visit unless the physician has first established a physician-patient relationship through an in-person encounter.
5. (5) If the written certification states that marijuana should be used for less than 1 year, the department shall issue a registry identification card that is valid for the period specified in the written certification.

History: En. Sec. 7, Ch. 419, L. 2011; amd. Sec. 9, I.M. No. 182, approved Nov. 8, 2016; amd. Sec. 14, Ch. 292, L. 2019.