Physician Certification Form is a State form that is signed by a physician, stating all of the following:

(1) The patient’s debilitating medical condition.

(2) The physician has completed a full assessment of the patient’s
medical history and current medical condition, including a relevant, in-person, medical evaluation.

(3) In the physician’s professional opinion, the patient is likely to receive therapeutic or palliative benefit from the medical use of marijuana to treat the patient’s debilitating medical condition(s) or alleviate symptom(s) associated with the condition.