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This is a sample prescription for medical cannabis including the strain type, cannabinoids, terpenoids, ingestion technique, THC:CBD ratio, and dosage - along with any particular notes concerning each patient.  Due to the variety and complexity of the plant, these are only guidelines as ingredients overlap and  components can vary widely. The dispensary agent will  also assist in selecting the proper materials and strains available to help treat each underlying condition for which medical cannabis was prescribed.  It is difficult to get exact quantities and ratios, select the closest items available...

                                

 Patient:   ________________________________________________________

Strain:     Sativa _____     Hybrid _____   Indica _____

 

Cannabinoids: THC (THCA) ___ CBD ___ (CBDA) ___ CBDV _____  CBC ___   CBG ___  CBGV___  THCV  ___  CBN __

 

Terpenoids: b-caryophyllene __ alpha pinene __ beta pinene __  myrcene __ limonene __  carene __ terpinoline __  linalool __  humulene __ geraniol __  borneol __  cineole __

 

Ingestion Technique:  

Vaporization ___       Smoking ___     Tablets ___     Tinctures ___

Ingestion ___     Dermal Patches ___     Topical Skin ___     Other ___

 

THC:CBD Ratio:  20:1    10:1    5:1    2:1    1:1    1:2    1:5    1:10    1:20

 

Dosage: THC 1 mg ___   THC 2 mg ___ THC 5 mg ___ THC 10 mg ___

THC 15 mg ___ THC 20 mg ___ THC 50 mg ___ THC100 mg ___

CBD 1 mg ___  CBD 2 mg ___ CBD 5 mg ___ CBD 10 mg ___

CBD 20 mg ___ CBD  30 mg __ CBD  50 mg ___ CBD 100 mg ___

 

Please consult with your dispensary agent as needed

                                

 

                                 

                                     

                                 

                                  

 

 

 

 

 

 

                                                                                                    

Dr. Stanley R Manstof - certified MMCC provider

                                      (301)471-4716