As a valued service to our patients, we will be happy to request your medical records from your primary physician. Start Now by filling out the Online Medical Release Form. We will receive the completed form to our email address (firstname.lastname@example.org) and forward it to your doctor of record to fax them to us. You will be notified by email as soon as the process starts.
It’s Fast and Easy, and will take about 2 minutes to complete.
Are you scheduled for your First APPOINTMENT?
Do your paperwork at-home. Complete your Medical History Intake Form Online. This will save you time at your appointment.
It’s Fast and Easy, and will take about 4 minutes.
In order to apply for a Compassionate Use Registry Identification Card each patient must: be a Florida resident, be diagnosed with a qualifying condition, and must have been added to the Compassionate Use Registry (and received a Compassionate Use Registry Patient Identification Number) by a physician licensed under Chapter 458 or Chapter 459, Florida Statutes, to receive low-THC cannabis, medical cannabis, or a cannabis delivery device from an authorized Florida dispensing organization.