Cannabis Checklist

The CCIC designed a checklist for health care practitioners considering cannabis as a treatment option. This page includes the checklist along with a link to provide feedback, information about the checklist and a description of how it was developed.

Download the checklist

Click here to download the : Checklist ( fillable form pdf )

Additional checklist documents:

Feedback on the checklist

Your feedback is encouraged! Please complete the online review & feedback survey:

Instructions for use

Checklist download and Instructions for use:
  1. By clicking the link or image above, a pdf of the Checklist will open in a separate window.
  2. Save the document on your computer.
  3. Open the document with Adobe Reader 9.0 or latest version.
  4. Complete the checklist by either printing it or by filling it in electronically.
  5. If filling it in electronically, you can make form fields easier to identify by clicking the Highlight Fields button on the document message bar.
  6. If filling it in electronically resave it once you have filled it in.
  7. Ignore any prompts to use the send function.
  8. If you are having trouble saving a completed checklist, try printing it as a pdf.
  9. Print the document and keep the checklist in your records.
  10. Do not return to CCIC any copies of the checklist on which you have noted any patient or clinical information.


About the checklist

The use of cannabis for medical purposes in most jurisdictions requires the support of a physician or other health care professional. Based on known risks of recreational cannabis use and prescription cannabinoids, some suggestions for screening can be made, but comprehensive guidance on screening and monitoring patients using cannabis for medical purposes is lacking.

To address the need for practical clinical tools, we designed a checklist from existing guidelines and recommendations of cannabis use under recreational and medical conditions. The checklist is intended to provide a framework for practicing clinicians to facilitate patient screening and monitoring.

Checklist development

The development of this checklist was completed in a systematic way with input from Canadian primary care and specialist clinicians. The foundations of the checklist stemmed from publications related to clinical use of cannabis and cannabinoids, and prescription cannabinoid product monographs. Evaluating construct validity enabled the potential role of the checklist to be considered, and to subsequently make additions, deletions and structural changes to improve practicality. Evaluations for construct validity were based on clinical expertise and pilot testing. The evaluation of content validity was quantitative and ensured that only relevant items were retained based on agreement of relevance among expert participants. The result is a practical clinical resource for Canadian HCPs when considering medical cannabis as a treatment option for a patient. For more information on the checklist development please contact


This checklist is intended to be a reference tool for the evaluation of a patient for medical cannabis by a health professional. This is not intended for use as a screening questionnaire. This is not a validated clinical guideline. It is intended to provide a basis for a thorough assessment of the patient, their health status, risk factors, contraindications and expectations, to guide specific examination strategies, and to establish goals for medical cannabis use and monitoring


  • Mac users: Do not use the "Preview" application to complete the form as some of your answers may not be saved properly. (This software might open your document by default on your computer).
  • Adobe Reader: If you do not have Adobe Reader of if your version is older than 9.0, please download and install the latest version of this free software on your computer. Warning: by default, the "Google toolbar" is included in the download. Uncheck this option if you do not wish to add it to your web browser. Get Adobe reader at:
  • Browser: The PDF should open if you are using Internet Explorer. The ability to open the pdf using other browsers is unknown. If you are having trouble opening the pdf see the next note below.
  • Version française: La version française de la liste de contrôle n’est pas disponible à ce moment, nous ajouterons sa pendant l'été 2016. Nous vous remercie de votre patience.