Online Health Questionnaire with Digital Certificate (PDF)

placeit-2.png
placeit-2.png

Online Health Questionnaire with Digital Certificate (PDF)

21.00

Your personal health information & responses will be reviewed by a California-licensed MD to determine if medical cannabis should be recommended for you.  If approved, you will receive a digital copy of the doctor's recommendation for medical marijuana.  Please note that the actual certificate with seal and ink signature is not included.

Add To Cart

It is important that you be truthful when completing the questionnaire so the doctor can identify whether your condition would benefit from cannabis therapy.  Our doctors will recommend medical marijuana only if it is indicated.  Rest assured that your medical records will be maintained in our HIPAA-compliant, secure system.  Any information you provide will NOT BE ACCESSIBLE by your health insurance company, employer, or any other entity.