Patient Agreement

Green Ticket Bakery

Medical Marijuana Patient Agreement

Pursuant to California Health and Safety Code 11362.775

I, hereby certify that I am a qualified patient suffering from a serious medical condition and have obtained recommendations or approvals from a licensed physician in the State of California to us medical cannabis (Marijuana) to treat my medical condition(s). Copies of my recommendation may be attached hereto.

As a qualified medical marijuana patient under California law, I choose to associate collectively or cooperatively to cultivate marijuana for medical purposes. All members of our medical marijuana collective will contribute labor, funds, or material, and all will receive medicine. We form this collective in accordance with California Health and Safety Code 11362.775, which states:

“Qualified patients, persons with valid identification cards, and the designated primary caregivers of qualified patients and persons with identification cards, who associate within the State of California in order collectively or cooperatively to cultivate marijuana for medical purposes, shall not solely on the basis of the fact be subject to state criminal sanctions under Section 11357, 11358, 11359, 11360, 11366, 11366.5, or 11570.”

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