Bloom Waiver

AZDHS Medical Marijunana Program


I understand that Bloom has ZERO tolerance regarding impaired intoxication, threats, profanity, violence, abusive language, or rude/uncivil behavior. Loitering, loud music, loud talking, littering, are NOT allowed in, on, or around the Bloom Dispensary property.

I agree and understand that failure to follow any dispensary rules and/or policies may result in immediate removal from the property and may result in the loss of future access to the facilities.

I understand and agree that Bloom Dispensaries reserves the right to refuse service to anyone, at any time, for any reason, and without a stated reason or explanation if Bloom management so desires.

Each time I visit a Bloom facility and prior to admittance I understand and agree that I will be required to verify that I am a registered qualifying patient and/or a registered designated caregiver by presenting a valid U.S. or State government issued photo ID in addition to the state issued MMJ card.

I hereby agree to keep all of my purchased items sealed/stapled in the bag/sack that I receive from a Bloom cashier, upon the conclusion of my transaction, until I have left the Bloom Dispensary property, which includes the parking lots and public areas directly adjacent to Bloom Dispensary, and, that I will not litter with any Bloom items.

I hereby agree that no consumption whatsoever of medical marijuana or any medical marijuana containing substance may take place anywhere on Bloom property or the adjoining public areas.

I hereby pledge to only use medical marijuana as permitted by the Arizona Medical Marijuana Act.

I hereby agree to never operate a motor vehicle while consuming, and or, under the influence of medical marijuana.

I hereby agree to keep all items containing medical marijuana out of the reach of children at all times.

I hereby agree not to bring any weapons of any kind inside Bloom Dispensary. Any weapons must be securely stored in your vehicle, and may not be un-holstered or displayed while on Bloom property.

I hereby pledge not to divert any product containing medical marijuana to anyone who is not allowed to possess marijuana pursuant to the AZ Medical Marijuana Act.

I understand and agree that Bloom will, as required by Arizona regulations, access the AZ Dept. of Health Services Medical Marijuana Verification System and determine for each registered qualifying patient for whom the marijuana is intended and any registered designated caregiver:

The registry identification card presented to a Bloom Dispensary agent is valid.

The person presenting the card is the person identified on the card.

The amount to be dispensed would not cause the registered qualifying patient to exceed 2.5 OUNCES

(70.875 grams) during any 14-day period.

I understand and agree that a Bloom State of AZ Licensed Dispensary Agent (D.A.) will, as required by Arizona regulations, access the AZDHS.GOV MMV System, and after making the determinations required above, but before dispensing the marijuana, enter the following information into the verification system:

The amount of marijuana that is being dispensed to the registered qualifying patient.

Whether it was dispensed directly to the registered qualifying patient or to the registered qualifying

patient's registered designated caregiver.

The date and time the marijuana was dispensed.

The registration certificate number of Bloom Dispensary and the D.A. card number of the Bloom D.A. who dispensed the marijuana.

I hereby agree that I am responsible for any additional persons that accompany me to Bloom Dispensary, and I understand that all visitors, caregivers, friends, drivers, must comply with the same rules that I agree to in this patient agreement. As such, I am allowed ONE visitor to accompany me to Bloom, and that 1 person must wait for me inside a motor vehicle.

Standing around in the parking lots outside of vehicles, loud music, revving of engines, speeding/driving recklessly, are all prohibited in Bloom’s parking areas. Thank you


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