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AZCS - El Mirage
AZ Organics
Curaleaf - Airport
Curaleaf - Bell & 19th Ave
Curaleaf - Camelback
Curaleaf - Gilbert
Curaleaf - Pavilions/83rd Ave
Curaleaf - Queen Creek
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Story Cannabis
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E-mail* This field is required.
8
Have you been experiencing Chronic Pain for 12 months or more?* This field is required.Must answer YES to be qualified for a Medical Marijuana card today
YESNO
9
What part of the body are you experiencing your chronic pain?* This field is required.Please name the part of the body
10
How long have you been experiencing this pain?* This field is required.Must be at least 12 month or greater to qualify
11
Using the scale from 1-10 please rate what level your pain is.* This field is required.
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Pain Scale
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Do you currently receive EBT/ Foodstamps?* This field is required.Must show proof
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13
Signature* This field is required.I acknowledge that one the doctor signs my certification there is no refunds
14
Take Photo of Arizona ID / Drivers License or US Passport* This field is required.
15
Please take a full headshot photo of yourself with no hat, or sunglasses on a plain wall background for your MMJ Card Photo* This field is required.
16
Marijuana Certification* This field is required.Enter a coupon code for discount!
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$99 will be charged to your credit card today. A fee of $150 is required by the Arizona Department of Health upon the processing of your certification with the state.
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