Welcome to Bloom La Vie Health’s La Fleur Health Package!

We will be establishing a physician-patient relationship to determine if a recommendation for the safe and therapeutic use of medical cannabis/marijuana can be made. The physician will determine the appropriate recommendation based on your medical history and does not guarantee that a recommendation for a medical card certification will be made. There are no refunds for the consultation.

Here at Bloom La Vie Health, our pricing system is very straightforward – just like it should be. We cut out the insurance middle-man, so we could focus on providing care. If you have questions, simply ask. We’re happy to walk you through anything. In the meantime, take a look at our Membership Fees, browse our Frequently Asked Questions, or sign up for a free consultation with Dr. Nedeau to see if we are a good fit for your needs.

No diagnosis or treatment of any kind will be evaluated during this visit.

Required documents to fill out and bring to visit with doctor

• Medical Records Release Form (Click to Download)

Important Links

State of Missouri

• Missouri Medical Marijuana Portal
• Missouri Medical Marijuana Patient Services

Pricing

What you can Expect from Bloom La Vie Health

• Bloom La Vie Health will request appropriate diagnosis documentation from your present treating doctor and/or past medical records if applicable
• If you qualify, Bloom La Vie Health’s doctor will provide a medical marijuana recommendation and NOT a medical marijuana prescription. Since marijuana is classified as a Schedule I drug, marijuana prescriptions are illegal
• Missouri medical cannabis card recommendations will be valid for up to one year
• Bloom La Vie Health is not affiliated with a medical marijuana distributor and by law cannot recommend a medical marijuana dispensary

What Bloom La Vie Health Expects from You

You must bring or send in the following required documents for your appointment.

• Photo ID issued by a state or federal government entity (one of the following)
• A valid Missouri Driver’s License
• A valid US Passport
• Missouri Identification Card
• Please be prepared to take a digital photo upon your arrival
• Proof of Missouri Residency (one of the following)
• Missouri Identification Card
• Current Missouri Motor Vehicle Registration
• Recent Missouri Utility Bill
• All applicable fees (non-refundable)

Cancellation Policy

We understand that life can get in the way, if you need to reschedule your appointment, please give Bloom La Vie Health a 24-hour notice. If less than 24-hour notice is given the following fee will be accessed.

Cancelled Appointments (Less than 24 hours):

• Member - $30
• Non-member - $50
• No-Show/No-Call Appointment: $30 (Member) $50 (Non-Member)

Notice of Privacy Practices

This notice describes how medical information about you may be used and disclosed and how you can get access to this information. Please review it carefully.

Uses and Disclosures

The following categories describe the different ways in which we may use and disclose your individually identifiable health information, unless you object:

Treatment

Your health information may be used by staff members or disclosed to other health care professionals for the purpose of evaluating your health, diagnosing medical conditions, and providing treatment. For example, results of laboratory tests and procedures will be available in your medical record to all health professionals who may provide treatment or who may be consulted by staff members.

Payment

Your health information may be used to bill and collect payment for the services and items you may receive from us. We may use your health information to bill you directly for services and items.

Health Care Operations

Your health information may be used as necessary to support the day to day activities and management of Bloom La Vie Health. For example, information on the services you received may be used to support budgeting and financial reporting, activities to evaluate and promote quality, to develop protocols and clinical guidelines, to develop training programs, and to aid in credentialing medical review, legal services, and insurance.

Appointment Reminders

Your health information will be used by our staff to contact you and send you appointment reminders.

Information About Treatments

Your health information may be used to send you information that you may find interesting on the treatment and management of your medical condition. We may also send you information describing other health related products and services that we believe may interest you. Updated 2/26/21 MLB

Law Enforcement

Your health information may be disclosed to law enforcement agencies to support government audits and inspections, to facilitate law enforcement investigations, and to comply with government mandated reporting.

Release of Information to Family/Friends

Our practice may release your health information to a friend or family member that is involved in your care, or who assists in taking care of you. For example, a parent or guardian may ask that a babysitter take their child for an appointment. In this example, the babysitter or friend may have access to this child’s medical information.

Patient Mass Communication

We may use your name and email address(es) and/or text numbers to contact you with bulk messaging. For instance, to share new promotions for the clinic, to send clinic newsletters, or to notify you of a physician’s upcoming absence, such as for vacations.

Other uses and disclosures in certain special circumstances

• Public Health Risks - (i.e. vital statistics, child abuse/neglect, exposure to communicable diseases, reporting reactions to drugs or problems with products or devices.)
• Health Oversight Activities
• Lawsuits and Similar Proceedings – May use or disclose in response to a court or administrative order, if you are involved in a lawsuit or similar proceeding or in response to a discovery request, subpoena, or other lawful process.
• Deceased Patients – May be required to release to a medical examiner or coroner. If necessary, we may also release information in order for funeral director to perform their jobs.
• Organ and Tissue Donation
• Serious Threats to Health or Safety
• Military - If you are a member of the U.S. or foreign military forces (including veterans) and if required by the appropriate authorities.
• National Security
• Inmates – Our practice may disclose your health information to correctional institutions or law enforcement officials if you are an inmate or under the custody of a law enforcement official. Disclosure would be necessary for the institution to provide health care services to you, for the safety and security of the institution, and/or to protect your health and safety or the health and safety of others.
• Worker’s Compensation Disclosures of your health information or its use for any purpose other than those listed above requires your specific written authorization. If you change your mind after authorizing a use or disclosure of your information, you may submit a written revocation of the authorization. However, your decision to revoke the authorization will not affect or undo any use or disclosure Updated 2/26/21 MLB of information that occurred before your notified us of your decision to revoke your authorization.

Your Rights

You have certain rights under the federal privacy standards. These include:

• The right to request restrictions on the use and disclosure of your protected health information for treatment, payment, or health care operations. You have the right to restrict our disclosure to only certain individuals involved in your care or the payment for your care, such as family members and friends. We are not required to agree to your request; however, if we do not agree, we are bound by our agreement except when otherwise required by law, in emergencies or when the information is necessary to treat you. You must make your request in writing to the attention of the Privacy Officer. Your request must be described in a clear and concise fashion: a) The information you wish restricted b) Whether you are requesting to limit our practice’s use, disclosure, or both c) To whom you want the limits to apply

• The right to receive confidential communications concerning your medical condition and treatment

• The right to inspect and copy your protected health information. We will provide a copy or summary of your health information, usually within 30 days of your request. We may charge a reasonable, cost-based fee. Our practice may deny your request to inspect and/or copy in certain limited circumstances; however, you may request a review of the denial.

• The right to amend or submit corrections to your protected health information. This request must be made in writing and submitted to Privacy Officer with reasons to support your request. We may deny your request if you ask us to amend information that is in our opinion:

  • Accurate and complete
  • Not part of the health information kept by or for the practice
  • Not part of the health information which you are permitted to inspect and copy
  • Not created by our practice, unless the individual or entity that created is not available to amend the information
  • We will provide a written explanation for any denial in 60 days.
  • The right to receive an accounting of how and to whom your protected health information has been disclosed. We will include all the disclosures except for those about treatment, payment, and health care operations, and certain other disclosures (such as any that you asked us to make). We will provide one accounting a year for free but will charge a reasonable, cost-based fee if you ask for another one within 12 months.
  • The right to receive a printed copy of this notice, even if you have agreed to receive the notice electronically. Updated 2/26/21 MLB

Requests to Inspect Protected Health Information

You may generally inspect or copy the protected health information that we maintain. As permitted by federal regulation, we require that requests to inspect or copy protected health information be submitted in writing. You may obtain a form to request access to your records by contacting your physician and/or privacy officer. Your request will be reviewed and will generally be approved unless there are legal or medical reasons to deny the request.

Bloom La Vie Health’s Duties

We are required by law to maintain the privacy of your protected health information and to provide you with this notice of privacy practices. We also are required to abide by the privacy policies and practices that are outlined in this notice.

Right to Revise Privacy Practices

As permitted by law, we reserve the right to amend or modify our privacy policies and practices. These changes in our policies and practices may be required by changes in federal and state laws and regulations. Upon request, we will provide you with the most recently revised notice on any office visit. The revised policies and practices will be applied to all protected health information we maintain.

Complaints

If you would like to submit a comment or complaint about our privacy practices, you can do so by sending a letter outlining your concerns to:

If you believe that your privacy rights have been violated, you should call the matter to our attention by sending a letter describing the cause of your concern to the same address. You will not be penalized or otherwise retaliated against for filing a complaint. Effective Date This notice is effective on or after 8/1/2020

FAQ’S

• What are the residency requirements to get a Medical Marijuana card in Missouri? You must be a resident of Missouri. The Missouri Department of Health and Senior Services (DHSS) will not allow out-of-state patients to apply for a Missouri Medical Marijuana card.

• Can I apply if I live out of state? Missouri does not grant medical marijuana licenses to out-of-state patients.

• What are the age requirements? You must be 18 years or older. Minors are not allowed to get a card. A parent or guardian of a minor seeking Medical Marijuana treatment may apply for a caregiver license, however.

• What is a primary caregiver? A Primary Caregiver is at least 21 years old and responsible for the well-being of a qualified patient. • Must be licensed by DHSS • Must be listed as the qualified patient’s caregiver on the application for an ID card and on the licensed qualified patient’s approved application • Caregivers must submit a Patient Authorization Form with their caregiver application. This document can be found on the DHSS website and must be both completed and signed by the qualified patient

• Can I choose my caregiver? Yes. Under qualifying circumstances, a license will be granted that provides a designated caregiver to licensed patients. The qualifying circumstances can be found on the application. You will, however, need to provide valid, documented information as to why you need a caregiver.

• What are the qualifying conditions for getting a Medical Marijuana License?

  • Cancer
  • Epilepsy
  • Glaucoma
  • Intractable migraines unresponsive to other treatment
  • A chronic medical condition that causes severe, persistent pain or persistent muscle spasms, including but not limited to those associated with multiple sclerosis, seizures, Parkinson’s disease, and Tourette’s syndrome
  • Debilitating psychiatric disorders, including, but not limited to, post-traumatic stress disorder if diagnosed by a state-licensed psychiatrist
  • Human immunodeficiency virus or acquired immune deficiency syndrome
  • A chronic medical condition that is normally treated with a prescription medication that could lead to physical or psychological dependence, when a physician determines that medical use of marijuana could be effective in treating that condition and would serve as a safer alternative to the prescription medication
  • Any terminal illness AND/OR
  • In the professional judgment of a physician, any other chronic, debilitating, or other medical condition, including, but not limited to, hepatitis C, amyotrophic lateral sclerosis, inflammatory bowel disease, Crohn’s disease, Huntington’s disease, autism, neuropathies, sickle cell anemia, agitation of Alzheimer’s disease, cachexia and wasting syndrome.

• What medical documentation do I need to apply? In Missouri, you will need valid identification and medical records regarding your condition when you visit a medical professional for an evaluation.

• How much am I allowed to own and purchase? In Missouri, a patient can have six (6) flowering plants in their home and can possess up to 4 ounces or a 60-day supply of dried marijuana.

• Where are the dispensaries? Dispensaries are located all over the state! Visit the interactive map on our homepage to find the dispensary that works best for your specific situation.

• How long does it take to get my card once I’ve applied? The Missouri Department of Health and Senior Services (DHSS) processes their applications within 30 days.

• How long does my patient license last? In Missouri, medical marijuana licenses are valid for one year from the date of issue.

• What does Article XIV Section One mean? Article XIV allows state-licensed physicians to recommend medical marijuana for certain qualifying conditions, provides patients the right to discuss possible benefits of medical marijuana, and establishes a patient’s right to use medical marijuana under the supervision of a physician.

• What is medical marijuana? Medical marijuana in Missouri refers to any strain of cannabis with a tetrahydrocannabinol (THC) content of greater than 0.3% on a dry weight basis. Products containing forms of cannabis or hemp or chemicals from cannabis or hemp with lower amounts of THC are not considered medical marijuana in Missouri.

• How can medical marijuana be used? Medical marijuana can be used in different ways such as inhalation through smoking and vaporization, by mouth with edibles, tinctures, capsules, and oils, sublingually by using products applied under the tongue like tinctures, dissolvable strips, lozenges, or sprays, or topicals like lotions, salves, bath salts or oils. It’s important to note that the different methods will affect you in different ways.

• Do people who qualify for a medical marijuana card in other states automatically qualify in Missouri? Just because someone qualified for a medical marijuana card in another state does not mean they automatically qualify in Missouri.

• What questions should I ask my doctor about marijuana?

  • What are the risks related to marijuana therapy?
  • Do the known benefits outweigh the risks?
  • Will marijuana therapy affect the use of any medications I am currently taking?
  • What side effects can be expected?
  • Will marijuana therapy be covered by my health insurance?

• If I turn in an incomplete application, what happens? If DHSS finds an application is incomplete, they will email the applicant’s email and will specify which information is missing. Applicants must resubmit the application with all information within 10 days of the email notification or their application will be denied.

• Why would an application for a medical marijuana ID card be denied?

  • Provides false or misleading information on the application
  • Fails to provide a complete application within 10 days of being notified that an application is incomplete
  • Receives two denials within a 12-month period, any subsequent application within that time period will be denied

• Who is legally allowed to possess medical marijuana in Missouri?

  • Only patients or their caregivers who have a valid DHSS-issued ID card.
  • A person with a pending qualified patient or caregiver application that has been filed with MMMP’s patient registry as long as they are able to produce their valid physician certification and show proof of pending registry.
  • An equivalent ID card or authorization issued by another state or political subdivision of another state will also meet the requirements for possession.
  • If requested, the possessor of medical marijuana must produce on demand to the appropriate authority, a valid ID card.

• What does a medical marijuana patient need to take to the dispensary to purchase medical marijuana? All you need is a valid Missouri medical marijuana identification card and your chosen form of payment.

• How much medical marijuana can I purchase from a dispensary? Qualified patients who do not cultivate or have medical marijuana cultivated on their behalf may have up to a 60-day supply (or eight ounces) of dried unprocessed marijuana or its equivalent.

• Can a licensed medical marijuana patient consume medical marijuana in public? A licensed patient shall not consume marijuana for medical use in a public place unless provided by law. 19 CSR 30-95.010(33) defines a public place as any public or private property, or portion of public or private property, that is open to the general public, including but not limited to, sidewalks, streets, bridges, parks, schools, and businesses.

• What information must a dispensary provide to their customers? All dispensary facilities must make available to all customers patient education materials that include at least the information described in 19 CSR 30-95.080(2)(B)1-5.

  • Local resources for concerns about addiction as well as the phone number for the Substance Abuse and Mental Health Services Administration’s National Helpline at 1- 800-662-4357.
  • Information about the different strains of medical marijuana available at that dispensary and the purported effects of the different strains.
  • Information about the purported effectiveness of various methods, forms, and routes of administering medical marijuana.
  • Information about potential risks and possible side effects of medical marijuana use, including the risk of poisoning and the phone number for the closet poison control center.
  • The prohibition on consuming marijuana for medical use in a public place, including the definition of what constitutes a public place according to this rule.

• What security regulations must be adhered to if you’re growing your own medical marijuana?

  • All qualifying patient cultivation shall take place in an enclosed, locked facility that is equipped with security devices that permit access only by the qualifying patient or by such a patient’s primary caregiver.
  • One qualifying patient may cultivate up to six flowering marijuana plants, six nonflowering marijuana plants (over 14 inches tall), and six clones (plants under 14 inches tall) at any given time in a single, enclosed locked facility.
  • Two qualifying patients, who both hold valid qualifying patient cultivation ID cards, may share one enclosed, locked facility. No more than 12 flowering marijuana plants, 12 nonflowering plants, and 12 clones may be cultivated in a single, enclosed locked facility, unless one of the qualifying patients, as a primary caregiver, also holds a patient cultivation ID card for another patient. In such a case, the primary caregiver may cultivate six additional flowering marijuana plants, six additional non-flowering marijuana plants, and six additional clones for a total of 18 flowering marijuana plants, 18 non-flowering marijuana plants, and 18 clones in a single, enclosed locked facility.
  • All cultivated flowering marijuana plants in the possession of a qualifying patient or primary caregiver shall be clearly labeled with the qualifying patient’s name.
  • DHSS-issued cultivation authorization shall be clearly displayed within the enclosed cultivation area and in close proximity to the marijuana plants. The authorization shall list the name of the qualifying patient or primary caregiver and the address of the facility in which that qualifying patient or primary caregiver is authorized to cultivate marijuana.
  • “Enclosed, locked facility” means— An indoor stationary closet, room, garage, greenhouse, or other comparable fully enclosed space equipped with locks or other functioning security devices that permit access to only the qualifying patient(s) or primary caregiver(s) who have informed DHSS that this is the space where they will cultivate marijuana.
  • An outdoor stationary structure means— That is enclosed on all sides, except at the base, by chain-link fencing, wooden slats, or similar material that is anchored, attached, or affixed to the ground and that cannot be accessed from the top.
  • In which the plants are not visible to the unaided eye from an adjacent property when viewed by an individual at ground level or from a permanent structure at any level.
  • That is equipped with locks or other security devices that permit access to only the qualifying patient(s) or primary caregiver(s) who have informed DHSS that this is the space where they will cultivate marijuana.