Authorization of Applicant

• As an applicant and/or responsible adult you acknowledge, attest, agree and consent to the following:
• The applicant is a permanent resident in Canada
• The information in the Argento Medical document is not being used to seek or obtain medical cannabis from another source.
• The Argento Medical Document is not being used to seek or obtain medical cannabis form another source.
• The Original Argento Medical Document accompanies the Argento Registration Application or has been/ will be sent separately.
• The applicant will use medical cannabis only for their own medical purposes.
• The applicant acknowledges that medical cannabis is not an approved therapeutic product and cannabis has not been authorized through the standard Health Canada drug approval process because the available scientific evidence does not establish the safety and efficacy of cannabis to the extent required by the Food and Drug Regulations for marketed drugs in Canada.
• The applicant acknowledges that using any medical cannabis or related products obtained from Argento Medical Inc. at their own risk.
• The applicant also specifically releases Argento Medical (and its service providers, officers, directors and staff) from any and all actions,claims, complaints, and demands for damages, loss or injury whatsoever, whether arising directly or indirectly as a consequence of the use of Argento Medical products or services.
• In order to receive our products and services, the applicant or responsible adult gives consent to Argento Medical to disclose the necessary personal information to Argento’s service providers.
• If the applicant is represented by an individual who is responsible for the applicant, the named responsible adult declares that they are responsible for the applicant. If the applicant resides in a residence such as a shelter, hostel, similar institution that provides food, lodging or other social services their name must be noted on this application.

The applicant and/or responsible adult consents to the healthcare practitioner that is providing the medical assessment to disclose to Argento Medical Inc. the applicant’s personal health information by phone, physical means or electronic means, for purposes of processing this registration (which may include the submission of the Argento Medical Document by electronic means and complying with the requirements of the Cannabis Regulations). The applicant understands and agrees that a copy of this – and registration application may be provided to the healthcare practitioner that is providing the medical assessment.