Before becoming a patient of Cannabis Care, we need to ensure that an individual meets the criteria set forth by the Pennsylvania Department of Health. Part of these crtieria include being a legal resident of Pennsylvania and having one of the pre-approved medical conditions. We also require that patients have medical records sent to us in advance of scheduling an appointment so that we may review them to see what treatments you have received for your approved diagnosis.
This webform is HIPPA secure.
By entering your name below and signature, you acknowledge that you are a resident of Pennsylvania and that you meet criteria for one of the Pennsylvania Department of Health approved medical conditions for medical marijuana. Upon signing this form, you will be able to enter the patient intake/medical history form for our review. You acknowledge that the patient-physician relationship will not officially commence (You will not officially become a patient under our care) until you arrive in our office for your appointment and we receive payment for your initial visit.