§2085.EXHIBIT A. DASA Form 229-1

(Hospital Letter Head)

 

 

Chief of Licensing

Department of Alcoholism and Substance Abuse

300 N. State Street–Suite 1500

Chicago, Illinois 60610

 

Sir:

 

We hereby apply for authorization from the Department to conduct research with Delta-9-Tetrahydrocannabinol.  Enclosed is a copy of Form DEA–225 "New Application for Registration under Controlled Substances Act of 1970", and a copy of our application to the National Cancer Institute (NCI) to participate in their research study.  The research will be conducted under the NCI approved Protocol I 80-12 "Group C Guidelines for the Use of Delta-9-Tetrahydrocanncbinol NSC 134454 for Nausea and Vomiting Induced by Antineoplastic Chemotherapy".  Applications for the individual physicians who have been approved by this hospital to issue the research order for medication are also enclosed.

 

We agree to comply with all pertinent Federal and State regulations and protocols concerning the use of THC.  We will notify the Department in writing of any new physician enrolled, or any who no longer wish to participate in the research study.

 

Sincerely,

 

 

Director of Pharmacy Services

Hospital Administrator