MedReleaf – Applicant Consent

In the case of a prospective patient, the user acknowledges that he or she is interested in learning more about MedReleaf and is considering becoming a patient in the future.

If the applicant has registered as a patient, caregiver or doctor the following applies:

By signing, the applicant and/or caregiver responsible for the applicant acknowledges that they have read, understood and agree that:

The Applicant ordinarily resides in Canada.

The information in this application and in the Medical Document to be sent is correct and complete.

The Medical Document is not being used to seek or obtain dried cannabis from another source.

The original Medical Document or one of the original Personal Use Production License (PUPL) or Designated Person Production License (DPPL) MUST be received by MedReleaf Corp. in order for MedReleaf Corp. to complete the patient registration.

The Applicant will use dried cannabis only for its own medical purposes.

The Applicant understands and acknowledges that medical cannabis is not currently approved for use as a pharmaceutical drug in Canada.

The Applicant acknowledges and agrees that he or she is using any medical cannabis product obtained from MedReleaf Corp. at his or her own risk, and releases MedReleaf Corp. (and its partners, providers, officers, directors and staff) from any and all actions, claims, complaints and demands for damages, loss or injury whatsoever arising directly or indirectly from the use of medical cannabis obtained from MedReleaf Corp.

The Applicant consents to MedReleaf Corp. collecting and disclosing necessary personal information in order to process this registration and to fulfill orders for medical cannabis in accordance with the MedReleaf Corp. privacy policy.

By signing below the applicant acknowledges that they have read, understood and agree that: MedReleaf may from time to time use personal health information (i.e. your condition(s), product selection) on an anonymous and aggregate basis for research and/or medical educational purposes. We may also ask you to complete surveys that we use for research purposes, although you do not have to respond to these.

The Applicant consents to their health care practitioner named in the Medical Document disclosing required personal health information to MedReleaf Corp. for the purposes of complying with the requirements of the Cannabis for Medical Purposes Regulations (MMPR). The Applicant understands and agrees that a copy of this consent & registration application may be provided to the health care practitioner.