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Medical Marijuana and Cannabis Dispensary Store - Massachusetts

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Medical Marijuana Patient Acknowledgement

Medical Marijuana Patient Acknowledgement

First-time Patients at ACS are encouraged to submit an acknowledgement form understanding the safety risks associated with Medical Cannabis.


By checking the box next to each statement listed below, I acknowledge and agree to the following:

I understand that my registration card only allows for the possession and use of medical marijuana within Massachusetts.(Required)
I have not applied for, nor received, a hardship cultivation registration, and I understand that my registration card does not allow me to cultivate marijuana for any purpose.(Required)
I will not engage in the diversion of marijuana, and I understand that fraudulent distribution or resale of medical marijuana is a felony punishable by up to five (5) years in prison.(Required)
I understand marijuana has not been analyzed or approved by the FDA.(Required)
I understand there is limited information on the side effects of marijuana.(Required)
I understand there may be health risks associated with using marijuana, even for medicinal purposes.(Required)
I understand marijuana should be kept away from children.(Required)
I understand that driving under the influence of marijuana is illegal, and machinery should not be operated while using marijuana.(Required)
I understand I may not distribute marijuana to any other individual, and must return unused, excess, or contaminated product(s) purchased at ACS to a ACS dispensary for disposal.(Required)
I agree at all times to abide by Massachusetts law in regard to my use of medical marijuana, and hereby release and waive all claims against ACS from any and all liability related to my use of medical marijuana.(Required)
I agree not to bring any weapons into any of ACS’s facilities.(Required)
I understand that ACS may refuse to dispense medical marijuana to me if, in the opinion of the agent, the public or myself will be placed at risk by so doing. In this event I understand that my certifying physician will be notified within 24 hours.(Required)
I have received the ACS patient handbook.(Required)
(If you haven’t done so yet, please click here to download the ACS Patient Handbook, then return to this page to check the box.)
Name(Required)
MM slash DD slash YYYY

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Bridgewater
693 Elm St.
Mon – Fri: 9 am – 7 pm
Sat – Sun: 10 am – 6 pm
Hull
175 George Washington Blvd.
Mon – Fri: 10 am – 7 pm
Sat – Sun: 10 am – 6 pm

508-356-5151

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All information displayed on this website is for educational purposes only, and is not to be construed as medical advice or treatment for any specific person or condition. Cannabis has not been analyzed or approved by the FDA. Individual results may vary. Please Consume Responsibly.
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