Med Pass Membership

Welcome to our VIP patient membership club! For only $19.99/month you will enjoy the following benefits:

- Enjoy a Lifetime Medcard with Full Privlages

- Come in and see a Provider in person up to 4 times a year OR

- Enjoy the convenience of tele-med renewals from home

- Qualify for a one year renewal (with Provider approval)

- 10% loyalty discount on all cannabis products at Empathetix

- 5% loyalty discount on Empathetix Wellness Services

- VIP Discounts, Promos, and Product Drops from UT Canna-Pharmacies

- Access to Future VIP Events

- A Portion of Each Monthly Payment Goes to the Charity of Your Choosing

- Discounts on Prescription Medications with our Pharmacy Partner

Name*

First NameLast Name

Phone Number*

Area CodePhone Number

Email*

example@example.com

Med-Card Expiration Date*

Date

Membership

Empathetix Membership($4.20 for the first month then,$19.99 for each month)

Sign-Up Payment $4.20

Credit Card

First Name

Last Name

Credit Card Number

Security Code

Expiration Month

Expiration Year

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

Charities avalible for donation:

Veteran's Cannabis Project: Veterans Cannabis Project is dedicated to improving U.S. military veterans’ quality of life through the opportunity of cannabis. We believe medical cannabis saves lives and that veterans deserve full, legal access. https://www.vetscp.org/

Last Prisoner Project: The Last Prisoner Project (LPP) is a national, nonpartisan nonprofit organization dedicated to cannabis criminal justice reform. We aim to end America’s policy of cannabis criminalization, as well as to repair the harms of this discriminatory and counterproductive crusade. https://www.lastprisonerproject.org/

Veterinary Cannabis Society: The Veterinary Cannabis Society is committed to bringing together veterinarians, pet parents, and cannabis companies to ensure the appropriate and safe use of medicinal cannabis in pets. https://veterinarycannabissociety.org/

Charity

Veteran's Cannabis ProjectLast Prisoner ProjectVeterinary Cannabis Society

I agree to pay $19.99/month and there will be no additional fee for all future
renewals. If I cancel my membership or if card is declined, I will be expected to pay the standard rate for next renewal (less any prior monthly payments made). Membership does not include state renewal fee ($15). If I fail to make membership payments, my med card may be de-activated. Monthly membership payments are non-refundable, but full credit shall be given towards your next renewal. You can cancel your membership anytime by calling customers service and patients may simply pay our standard renewal rates.

Signature*

Sign Up for Our Cannabis Membership Today