CERTIFICATION FOR THE USE OF CANNABIDIOL OIL OR THC-A OIL - dhp virginia 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering the NAME OF PATIENT in the designated field. If applicable, you can also fill in the NAME OF PARENT/LEGAL GUARDIAN if the patient is a minor.
3. Specify whether the certification is for treatment of intractable epilepsy for the patient or incapacitated adult by selecting the appropriate checkbox.
4. Fill in the EXPIRATION DATE by either selecting one year from today’s date or specifying an earlier date as needed.
5. Complete the ADDRESS OF PATIENT section with accurate details to ensure proper documentation.
6. The practitioner must PRINT their NAME, SIGNATURE, and provide their ADDRESS and TELEPHONE NUMBER in the respective fields.
7. If necessary, complete any additional sections related to court information and delivery method for certification.

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