Consultation Intake FORM

Step 1 of 2

  • (please include two letters if you have the green card)
  • (if seeing the physician through telemedicine)
  • (initial)
  • Medical Marijuana Consultation is a thorough medical history consult regarding symptoms and diagnosis where Cannabis would be an appropriate medicine. One Medical Document will be completed annually. Additional forms, including OSDP, and insurance will require a fee.

    By signing this contract you are agreeing to the terms outlined above.