Terms of Service


T.C. Method
A Qualified California Cooperative Corporation
Membership Agreement

 

1. MEMBERSHIP APPLICATION & AUTHORIZATION TO RELEASE INFORMATION

As a qualified patient protected by California Law, Health and Safety Code § 11362.1 et seq., and in conjunction with California State and Senate Bill 420, you are required to read and agree to the following statements to become a member of T.C. Method, herein “the Cooperative.” Please review the following acknowledgements and understand that these acknowledgements are for the protection of the Cooperative.

I consent to the benefits provided by the Cooperative and agree to abide by the Bylaws, rules, and regulations of the Cooperative. I agree that as a member of the Cooperative any and all medical cannabis and cannabinoids provided to me by T.C. Method shall not be distributed by me in any unauthorized or illegal manner.

 

2. MEMBER’S SIGNATURE MEMBERSHIP GUIDELINES

T.C. Method, herein “the Cooperative,” is dedicated to providing the highest quality of service to our members. The Cooperatives was created in order for members to collectively associate and cultivate Cannabis for medical purposes.

We require our members to follow the guidelines below. They are designed to provide a safe and secure atmosphere for everyone. We practice a “Good Neighbor Policy” with our community and work hard to establish positive relationships with our neighbors, the city, and the police department. Please be respectful of your neighbors and their rights to privacy and property. Remember, not everyone shares our opinion about medical marijuana.

ALL MEMBERS MUST BE QUALIFIED PATIENTS BEFORE MEMBERSHIP IN THE COOPERATIVE WILL BE ACCEPTED. You must have the original copy of your doctor’s recommendation and a valid California ID, Driver’s License, or State Medical Marijuana Identification Card at the time of registration and delivery for continued access to our members’ services.

You must be at least eighteen (18) years of age. You may NEVER SELL or otherwise distribute medication you obtain from the Cooperative. If you do so, your membership will permanently REVOKED. If you disturb the Cooperative of threaten violence on any person or staff, your membership will be REVOKED. For your safety, our delivery concierge places all medication in a bag or out of sight when delivering medication to you. The Cooperative reserves the right to refuse service or revoke membership to members who violate our guidelines or bylaws. I have read and understand the above guidelines and agree to abide by these guidelines when I order a delivery from T.C. Method.

 

3. HIPAA/CMIA AUTHORIZATION

I am either the Patient named above or the Patient’s legally authorized representative. This release authority applies to any information governed by the Health Insurance Portability and Accountability Act of 1996 (HIPAA), 42 U.S.C § 1320d and 45 C.F.R. § 160-164, and/or information governed by the California Confidentiality of Medical Information Act (“CMIA”) Cal. Civ. Code §§ 56-56.37. Specifically, this release authority complies with the valid authorization requirements of 45 C.F.R. § 164.508(c). Pursuant to HIPAA and/or CMIA, I authorize and direct any physician, health care professional, dentist, health plan, hospital, clinic, laboratory, pharmacy, or other covered health care provider, any insurance company, and the Medical Information Bureau, Inc., or other health care clearinghouse that has provided treatment or services to me or that has paid for or is seeking payment from me for such services, to give, disclose, and release, with restriction, all of my individually identifiable health information and medical records regarding my past, present, and future medical or mental health condition, to include all information relating to the diagnosis and treatment of sexually transmitted diseases, mental illness, and drug or alcohol abuse to T.C. Method.

The purposes of the usage and disclosure shall include determinations regarding my qualification to use medical marijuana and monitoring my health care to protect my legal rights where I reside. I understand that, with certain exceptions, I have the right to revoke this Authorization at any time. If I want to revoke this Authorization, I must do so in writing. The procedure for how I may revoke this Authorization, as well as the exceptions to my right to revoke will be performed in accordance with applicable federal law and any applicable policy of my health care provider.
I understand that I may refuse to sign this Authorization. If I refuse to sign, I understand that I cannot become a member of this cooperative. I also understand that my health care provider cannot deny or refuse to provide treatment, payment, and enrollment in a health plan or eligibility of benefits if I refuse to sign this Authorization.

I understand that, once information is disclosed pursuant to this Authorization, it is possible that it will no longer be protected by applicable federal medical privacy law and could be re-disclosed by the person or agency that receives it; however, I do not authorize such secondary disclosure. The authority given to the persons or parties named above shall supersede any prior agreement that I may have made with my healthcare providers to restrict access to or disclosure of my individually identifiable health information. The authority given has no expiration date and shall expire only in the event that I revoke the authority in writing and deliver it to my health care provider. I have read and understand the information in this Authorization form.

 

5. UPLOAD YOUR DOCUMENTS

We need to verify you identity. Please upload a photo of your state ID.

To comply with state law, please provide a valid Medical Marijuana Recommendation letter or ID card.

 

6. MMJ Recommendation Information

Driver’s License Number

Who is your Physician?

Physician ID Number

 

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Document name: Terms of Service
Unique Document ID: fe83d2cd1c0416e75f672e807f23a46bdd44a9c4
Timestamp Audit
2015-10-28 00:37:55 PSTTerms of Service Uploaded by TCM Support Team - support@thecannabismethod.com IP 76.174.22.177