Clinic Physician Instructions:

Michigan Marijuana Forms is a secured Medical Record information application system designed to assure physicians properly fill out the Michigan Medical Marijuana Application. It will also generate a clinical medical record/office visit note that satisfies the requirements for not only a bonafide dr/pt relationship but a section 8 defense for patients.


Specifically the following points are addressed:

  • The statutory language from the MMMA is stated at the start of the note
  • Confirmation of a face to face visit with the patient
  • Review of medical records is documented
  • Discussion on methods and amounts of cannabis to treat the patient’s condition
  • An offer was made to notify the patient’s primary care physician (with documentation of name and fax number if notified)
  • Arrangements for follow up with the patient are documented

Output Generated:

  • The application completes both pages (patient and physician) of the current Michigan Medical Marihuana Application Packet.  Both are typed and correctly filled out with no missing information to reduce denials.  A copy of the drivers license is printed with the application.  Add a check to the state and it is done.
  • A complete and separate medical record of the clinic visit is generated.  While elements are added to the base note as the conditions are checked, the entire note is fully editable (with spell check) by the physician.
  • The patient Medical Records used as the basis for the certification are scanned at the time of the visit and attached to the record, but not printed.  They can be accessed at any time for review and printing as needed.
  • All documentation (application, note, records) are organized and easily uploadable to the practice EMR or for printing for the paper chart, according to what ever system the office uses.

Instructions for Clinic Physicians:

  1. For the first use, the clinic physician profile is displayed, allowing the physician to review and modify according to their preferences.
    • Passwords can be changed at will.
    • Clinic Location is set (either a fixed location or changed to reflect current clinic for multible locations)
    • Statutory language is defaulted to clinic standards (but may be modified by individual physicians as desired).  If the clinic default is used, it automatically updates if the clinic administrator changes the defaults.
    • Physician can select 3/6/12 month patient follow ups.
    • The Clinic Physician can review the default notes for each condition.  These can be left as defaults or modified as desired by the physician.
  2. Once profile is saved, the clinic physician clicks the ‘home’ button to reach the clinic home screen.
    • Left circle brings up the profile page to change clinic location, password, or documentation as above.
    • Right circle brings up a ‘staff page’ to allow the physician personally check a patient into the clinic (useful for single certifications or if assisting staff is not available).
    • The center circle opens the physician screen for the visit.
  3. To start seeing patients, go to the physician home screen and select the middle circle.
    • Select the patient from the drop down list on the upper right.
    • Check off the appropriate conditions.
    • Review the generated note and add details as needed.
    • During the course of the visit, collect the appropriate medical records.  The physician can scan and upload these directly, or delegate that job to the support staff.
  4. When finished with the visit, simply hit ‘Submit’ and print as many copies of the application as needed for patient, state and caregiver.
  5. Put original signatures on the application.
  6. Send the patient to checkout, make sure staff reviews the application for completeness.