Practitioner Written Certification Form for Use With Autism Spectrum Disorder Diagnosis - Rhode Island

Practitioner Written Certification Form for Use With Autism Spectrum Disorder Diagnosis is a legal document that was released by the Rhode Island Department of Health - a government authority operating within Rhode Island.

FAQ

Q: What is the Practitioner Written Certification Form?
A: The Practitioner Written Certification Form is a document used in Rhode Island for obtaining a medical marijuana card for individuals with Autism Spectrum Disorder.

Q: Who can fill out the Practitioner Written Certification Form?
A: Only licensed medical practitioners in Rhode Island, including physicians, nurse practitioners, and physician assistants, can fill out the form.

Q: What is the purpose of the form?
A: The form is used to certify that an individual has a qualifying medical condition, in this case, Autism Spectrum Disorder, which would benefit from the use of medical marijuana.

Q: How can I obtain the form?
A: You can obtain the Practitioner Written Certification Form from a licensed medical practitioner in Rhode Island who is knowledgeable about your condition.

Q: What information is required on the form?
A: The form will require information such as the patient's name, date of birth, qualifying condition diagnosis, medical history, and the medical practitioner's signature and contact information.