Compassionate Use Board petition guide for medical conditions

We ask for specific information for some medical conditions because it helps us make an informed decision about the patient’s petition.

Click on each button to see the specific information for each medical condition:


Anxiety

Medical diagnosis

List an anxiety disorder diagnosed using DSM-V criteria. 

Diagnosis being intractable

Include the following information for FDA-approved anxiety medications your patient has tried: 

  • The medication name 
  • How long they took the medication
  • Why it didn’t work  

Include the following information about mental health treatments your patient has tried:  

  • Which types of mental health treatment they’ve received
  • If they’ve completed a full course of CBT. 

Other information to include in the petition

Include information that shows you’ve ruled out other medical conditions, specifically thyroid conditions. You can include this information anywhere in the petition.


Autism

Symptoms

Describe the specific symptoms of autism that medical cannabis will treat.  

Quality of life 

Include the following information about the patient:

  • Any self-injuries
  • Harm caused to others 
  • Destruction of property
  • Other safety risks for the patient

Diagnosis being intractable

Include the following information for FDA-approved medications your patient has tried to treat their autism symptoms: 

  • The medication name 
  • How long they took the medication
  • Why it didn’t work  

Include the following information for other behavioral interventions your patient has tried to treat their symptoms. 

  • The intervention name
  • How long they used the intervention
  • Why it didn’t work for them

Chronic pain

SOAP note

Your note should include a detailed physical assessment of the patient and their pain. 

Other documentation

Upload past medical records that support the patient’s chronic pain diagnosis and show how long the patient has been experiencing pain.

Upload medical records that show other medical interventions the patient tried before medical cannabis. These can include the following:

  • Chiropractic notes
  • Consultation notes from other medical providers 
  • Physical therapy notes
  • Radiology reports
  • Surgical reports
  • Pain clinic notes

Epilepsy

Diagnosis being intractable

Include the following information for FDA-approved epilepsy medications your patient has tried: 

  • The medication name
  • How long they took the medication
  • Why it didn’t work for them

Other documentation

Upload records showing an epilepsy diagnosis from a medical provider who specializes in epilepsy.


Insomnia

Diagnosis being intractable

Include the following information about other mental health concerns:

  • Other mental health concerns they’ve been evaluated for
  • The types of mental health treatment they’ve received 

Other information to include in the petition

Include information that shows the sleep hygiene practices that the patient has tried. You can include this information anywhere in the petition.


Post-traumatic stress disorder (PTSD)

Diagnosis being intractable

Include the following information for FDA-approved medications your patient has tried to treat their PTSD symptoms: 

  • The medication name
  • How long they took the medication
  • Why it didn’t work for them

They must also be receiving current mental health treatment and have tried other therapies recommended to treat PTSD. Include the following information: 

  • The types of mental health treatment they’ve received.
  • The types of therapies they’ve tried. 

Patient current treatment with licensed mental health provider

Verify that the patient is currently receiving treatment from a licensed mental health professional. 

Licensed mental health provider and credentials

Provide the following information about the patient’s licensed mental health professional:

  • Their name
  • Their credentials (MD, DO, PA, NP, LCSW, etc.) 

Name of diagnosing provider

Provide the name of the provider who diagnosed the patient with PTSD or confirmed the diagnosis.

Credential of diagnosing provider

Provide the credentials of the provider who diagnosed the patient with PTSD or confirmed the diagnosis (MD, DO, PA, NP, psychiatrist, etc.)

Trauma type

Describe the type of trauma that caused PTSD. 

Types of therapies tried

List the types of therapies the patient has tried to treat PTSD. For example:

  • Cognitive behavioral therapy (CBT)
  • Eye-movement desensitization and reprocessing (EMDR)
  • Trauma-focused cognitive behavioral therapy (TFCBT)

Other documentation

Upload a letter from the patient’s licensed mental health provider that confirms the following information:

  • The patient is currently receiving mental health counseling
  • The patient’s mental health providers are aware of the patient’s medical cannabis application
  • If you weren’t able to contact the mental health providers explain why