RX
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