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08-22-2010, 12:59 AM #1OPSenior Member
Professional Medical Marijuana Assessment in Washington State
Dr. Gil's Clinic
Gil Mobley, MD
Dr. Gil's Clinic
33530 First Way South
Suite 102
Federal Way, Washington 98003
(206)330-2215
Dr. Gil's Clinic — MMJ assessment
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Social Security: _______-______-_________ Date of Birth: __________________________
Address: ____________________________________________ Home/Cell Phone: ________________________________
I authorize _______________________________ to provide a copy, summary, or narrative of my medical records (as indicated by the check mark(s) below) or to otherwise release confidential information. At this time I am requesting the following:
__________ Complete record (History & Physical Exam, Lab Report, X-Ray Report, Consultation Report)
__________ Records of care from _____________________ to ________________ only
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Dr. Gilā??s Immediate Care
33530 1st Way S. Suite 102, Federal Way, WA 98003
Fax: (253)237-0701 Telephone: (206)330-2215
PURPOSE OF DISCLOSURE: CONTINUING CARE
I understand that you will provide this information within 15 business days from receipt of request.
I understand that this authorization will expire in 12 months from the date thereof unless otherwise specified. A photo copy will be considered as valid as the original.
I UNDERSTAND THAT MY TREATMENT MAY NOT BE CONDITIONED ON MY COMPLETION OF THIS AUTHORIZATION FORM EXCEPT WHEN THE PROVISON OF HEALTH CARE IS SOLEY FOR THE PURPOSE OF CREATING PROTECTED HEALTH INFORMATION FOR DISCLOSURE TO A THIRD PARTY.
1. Purpose. As a patient,, I authorize Dr. Gilā??s Immediate Care to use and disclose my individual health information for the purpose of conducting the research for medical records.
2. Individual Health Information to be Used or Disclosed. My individual health information that may be used or disclosed to conduct this research includes: Substance Abuse, Mental Health, Psychotherapy notes and HIV related information from hospitals, clinics, health care providers, and health plans that provide my health care during the treatment.
3. Parties Who May Receive or Use My Individual Health Information. The individual health information disclosed by parties listed in item 3 and information disclosed by me during the course of the research may be received and used by Dr Gilā??s Immediate Care.
4. Right to Refuse to Sign This Authorization. I do not have to sign this Authorization. If I decide not to sign the Authorization, I may not be allowed to participate in this treatment. However, my decision not to sign this Authorization will not affect any other treatment, payment, or relationship with the Dr. Gilā??s Immediate Care.
5. Right to Revoke. I can change my mind and withdraw this Authorization at any time by sending a written notice to inform my decision. If I withdraw this Authorization, the researcher may only use and disclose the protected health information already collected for this treatment. No further health information about me will be collected by or disclosed to Dr. Gilā??s Immediate Care.
Signed: ___________________________________ Date: ________________
(Patient or person legally authorized to consent on patients behalf)jamessr Reviewed by jamessr on . Professional Medical Marijuana Assessment in Washington State Dr. Gil's Clinic Gil Mobley, MD Dr. Gil's Clinic 33530 First Way South Suite 102 Federal Way, Washington 98003 (206)330-2215 Dr. Gil's Clinic — MMJ assessment Rating: 5
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08-22-2010, 04:28 PM #2Senior Member
Professional Medical Marijuana Assessment in Washington State
How much $?
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08-22-2010, 05:20 PM #3OPSenior Member
Professional Medical Marijuana Assessment in Washington State
Originally Posted by killerweed420
I "guess" 200...never called yet. I just know he ain't a doc-in-the-box just like havsey isn't.
Dr. Gil is the dr. who commented at the doh add a condition hearing last yr. for mental health conditions. Seems the mental health conditions are not available since that specialty is not on the doh list....
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08-24-2010, 06:13 PM #4OPSenior Member
Professional Medical Marijuana Assessment in Washington State
Spoke with Gil today, and he said:
$ 200 bucks and he doesn't do over 15/24 because of the mower/reed case in mason co. showed him patients who go over 15/24 must have some serious medical issues with serious documentation....
In otherwords, he felt it could jeopardize the patients and his med. lic. to go over the baseline...
Someone forgot to tell him it is now a prescription in wa....my bad.
He is not fond of the dibs either.
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08-24-2010, 08:15 PM #5Senior Member
Professional Medical Marijuana Assessment in Washington State
Karen was dieing and that isn't enough to prove the need. SO I kind of agree with him. It gets risky with over the guideline amount. One of the biggest problems is having a narc officer getting on the stand and saying an indoor plant produces 1 pound of finished product. So I guess everyone grows 15 pounds per cycle.lol
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08-24-2010, 08:54 PM #6OPSenior Member
Professional Medical Marijuana Assessment in Washington State
Unfortunately, i must disagree. That was a hiatt case...hiatt fumbled huge in my opinion..and to this very day still does.
Back when OUR grays harbor house got raided, steinborn and hiatt attempted to get us to use "carter" as our new found M.D. for our open-ended orvald recommendations...this was 4 yrs ago...i smelt it then, and still do...BULLSHIT!!
Funny this was, that law office represented the renter, not us...was sure a ploy in our book...this would have dissolved the relationship with orvald via coercion, not willfully. ...and the renter would have been charged for growing our meds... just some tricks i have learned from dealing with the wa. supreme ct. dba the state of wa.!!
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08-24-2010, 09:06 PM #7OPSenior Member
Professional Medical Marijuana Assessment in Washington State
Originally Posted by DankDragon
Gil is very talkative. Some in the field have patient ethics in mind..HIPPA. Havsey has already had medical bd. issues...am sure he wants to avoid another hippa issue.
Was trying to get gil to open a clinic in s.w. wa....in time he said..in time.
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08-24-2010, 09:22 PM #8OPSenior Member
Professional Medical Marijuana Assessment in Washington State
Originally Posted by killerweed420
I personally thank fools like this..cause they really help out the cause, the "lack" of probable cause to seize..look at .050...the second they take more than a sample...it has been seized &forfeited to the court as a result.
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08-25-2010, 06:01 PM #9Senior Member
Professional Medical Marijuana Assessment in Washington State
Originally Posted by jamessr
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08-25-2010, 06:03 PM #10Senior Member
Professional Medical Marijuana Assessment in Washington State
Originally Posted by jamessr
How could you fumble in bringing one of the foremost experts in cannabis dosing to the stand?
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