A valid authorization is completely filled out by the patient’s authorizing healthcare practitioner (doctor) and must:

• be completed on the on the Department of Health form number DOH 630-123. Any other form of recommendation, prescription or authorization is invalid;

• printed on tamper-resistant paper (see below);

• Include an original signature by the healthcare practitioner, along with the authorization date and expiration date no more than 1 year from date of authorization; or six months for patients under the age of 18