Marijuana Disclosure form

Marijuana Interaction with Other Drugs Form

The Michigan Osteopathic Association (MOA) recognizes the complex issues involved in patient treatment and prescribing medications. Any patient treatment must include knowledge of prescription and non-prescription drug use. Unlike prescription drugs, there is very little research available on (and limited reliable studies) the effects of the interaction of marijuana and prescription drugs. Due to the lack of studies/research a physician cannot predict what, if any, effects there will be resulting from using marijuana with the prescription and nonprescription drugs that are to be used in the course of treatment. A physician simply must know when a patient is using marijuana. 

The MOA offers the "Marijuana Interaction with Other Drugs" form. The legal disclaimer and acknowledgement form is an agreement to hold harmless a physician for any negative outcome if the patient takes prescriptions in conjunction with marijuana.

To download the "Marijuana Interaction with Other Drugs" patient disclosure form as a PDF file, click HERE.