PATIENT INTAKE FORM - Caring Nature Dispensary
2. Qualifying Condition: Patients 18 years of age or older: Amyotrophic Lateral Sclerosis Cancer Cachexia Cerebral Palsy Complex Regional Pain Syndrome Crohn’s Disease Cystic Fibrosis Damage to the Nervous Tissue of the Spinal Cord with Objective Neurological Indication of Intractable Spasticity Epilepsy Fibromyalgia, spasticity/neuropathic pain associated with ................
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