RENEWAL CONSENT — CANNABOX MD

Before submitting your renewal request, please review and confirm the following:

Renewal consent confirmations

1. Accuracy of Information

☑ I confirm that all personal, medical, and contact information I have provided for this renewal is accurate, complete, and truthful.

I understand that providing false or misleading information may result in denial of my renewal and may violate Thai medical regulations.

2. Eligibility for Medical Cannabis

☑ I confirm that I am at least 20 years old.

☑ I confirm that I am not pregnant or breastfeeding.

☑ I understand that medical cannabis is a controlled herb and must be used only as prescribed.

3. Clinical Assessment for Renewal

☑ I understand that renewal is not automatic. A licensed practitioner will review my information and may approve, modify, or decline my renewal based on medical appropriateness.

☑ I understand that the practitioner may request additional information or require a telemedicine consultation if necessary.

4. Telemedicine Limitations (Short Form)

☑ I understand that telemedicine has limitations and may not replace an in-person medical assessment.

If symptoms have changed or worsened, I agree to seek further medical evaluation when advised.

5. Consent to PDPA Data Processing

☑ I consent to the processing of my personal and medical data for the purpose of renewing my medical cannabis prescription, in accordance with the Privacy Policy.

This includes sharing relevant information with licensed practitioners, clinics, dispensaries, and authorities where legally required.

6. Consent to Recording (Only If Video Consultation Required)

(Display only if the practitioner triggers a video call)

☑ I consent to audio/video recording and image capture for identity verification and regulatory compliance, as required under DTAM telemedicine standards.

7. Acknowledgement of Legal Obligations

☑ I understand that medical cannabis may cause drowsiness or impaired judgment and I will not drive or operate machinery after use.

☑ I will store cannabis securely and not share, resell, or transfer it to others.

☑ I understand that misuse or unlawful possession is subject to Thai law.