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Patient Disclosure, Release, and Waiver of Liability


The Greener Institute provides clinical guidance from physicians on using cannabis to treat certain diagnoses, including recommendations on the strain, formulation, and dosing principles. Cannabis can have contraindications or produce side effects. You should not use Cannabis products if you are pregnant have a personal or family history of a Psychotic Disorder including but not limited to Schizophrenia, Depression with Psychosis, Thought Disorder, Postpartum Depression, and Bipolar Affective Disorder Type I. If you experience any side effects from cannabis, you should immediately stop use and contact your primary care physician and/or cannabis physician immediately and if they are immediately unavailable, go to the nearest hospital emergency room. If your ability to operate a motor vehicle is impaired, you should call 911 for an ambulance.

Cannabis is considered an experimental treatment, and more research is being performed to explore the benefits and risks of use. Cannabis use is not approved by the Food and Drug Administration. You should consult with your Primary Care Physician prior to the use of Cannabis products. Other issues outside of cannabis treatment should be directed to a primary care physician or specialist in a given field.

By accepting this Disclosure, Release, and Waiver of Liability, I hereby acknowledge that: *
And acknowledge that: *

By typing your name, you are signing this Agreement electronically. You agree your electronic signature is the legal equivalent of your manual signature and consent to be legally bound by this agreement's terms and conditions.

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