Patient & Customer Intake Form
Please fill out the following sections, as well as read the rules and regulations on the opposite side, sign and date, and return the completed form to the Receptionist.
Local’s Cannabis Code of Conduct
To maintain a safe environment for ALL customers and staff, the following conduct is expected of all persons who enter this dispensary:
- Privacy and Security: For the protection of our patients’ privacy and security, no photography or video recordings are permitted in the dispensary.
- Food and Beverage: No food or beverages may be consumed on the sales floor during hours that cannabis is being dispensed, unless necessary for medical reasons.
- Loitering: No loitering outside of the dispensary before or after completing a transaction.
- Consumption: No consumption or vaporization of cannabis in the dispensary, the parking lot, or the surrounding area.
- Product Handling: I will not open any cannabis product package in the dispensary or parking lot. Wait until reaching a private residence/property before opening any cannabis product. Open products in the vehicle or in public may violate local and state laws.
- Distribution: Do not distribute, sell, or share your cannabis products. Doing so violates local and state laws.
- Respectful Behavior: Any inappropriate action or language is cause for being asked to leave the dispensary. Repeated offenses will result in a permanent refusal of service.
- Authorization: I acknowledge that I am authorized to purchase medical marijuana in Ohio as a patient or as a caregiver on behalf of the patient identified in this transaction.
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This facility reserves the right to stop dispensing medical marijuana to me if unable to follow the following guidelines:
- If my behavior is inconsistent with the responsibilities listed above.
- If I am misusing medical marijuana or other drugs.
- If I enter the dispensary impaired and unable to operate a vehicle without a designated driver/caregiver.
- If I conduct myself in a disruptive, offensive, or belligerent manner towards employees or patients while in the dispensary.
- If caught using cannabis in Local’s Cannabis’s parking lot.