Patient Declaration & Consent

By submitting the patient registration form including declaration and consent:

• I consent to treatment with medicinal cannabis/cannabinoid medications.

• I understand that there is limited evidence on the efficacy of medicinal cannabis and is not the first line treatment for any medical condition. Acute and long term side effects are not well-known and I accept full responsibility for any risks associated with use of medicinal cannabis.

• I understand that medicinal cannabis is still an unregistered medication in Australia by the Therapeutic Goods Australia (TGA). Therefore, access to medicinal cannabis need to be made through a Special Access Scheme or Authorised Prescriber scheme.

•  I agree to have regular follow-ups as indicated by Dr Shu, and report any adverse effects and changes to other medications. Dr Shu may report my treatment outcomes to the state government.

• I understand that the cost of medicinal cannabis or organising reimbursement by third parties is solely my responsibility.

• I understand that medical cannabis can impair my ability to drive, operate other vehicles/heavy machinery, or make important decisions. It is an offense to drive in Australia with any level of tetrahydrocannabinol (THC) in my blood, urine or saliva. A legally issued prescription is not protective against these laws.

• I understand that medicinal cannabis interactions with other medications are not well known, and I accept risks associated with any interactions that may occur.

• I agree to share my clinical outcomes for research purposes.

• I agree to receive communications from Dr Shu in the form of SMS, email, post and telephone

• I understand that if I do not provide at least 24 hours’ notice to cancel or change my appointments I will be charged a nonrefundable cancellation or ‘no show’ fee.

• I understand that aggressive behaviour is not tolerated and could result in discharging me from the practice.

• I declare that all answers provided in the registration form and consultations are true and correct to the best of my knowledge and belief.