Your Full Name *
Your Telephone Number *
Your Email *
Your Date of Birth
Select Your Medical Condition
Chronic PainInsomniaStressAnxietyDepressionAppetiteHeadachesNauseaPTSDArthritisBack PainMuscle SpamsHIVMigrainesOther
Describe Your Medical condition
Your Past Treatments
Your Current Treatments
How is your condition affecting your life?
I understand that CannabisAdvocates.ca does not replace my family doctor.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.
Enter Today's Date *
Cannabis Advocates | 6900 Boulevard Décarie, Montréal, Quebec Canada H3X 2T8 | 1-800-554-0417 | (514) 447-3751