Patient Sign Up Form

 In order to sign up for medical cannabis consultation with Professional Cannabis Consulting Inc. please read and answer the following first 10 questions carefully and honestly.

 Our staff are committed to helping you find a certified, caring Healthcare Practitioner to suit your individual needs. Medical cannabis isn’t  for everybody and a few patients may require additional consideration or documentation to be approved.

 On the off chance that your response to the accompanying first 10 inquiries is YES (other than your age), you will not be able to advance to the second step form, and will require an extra note from your Community Healthcare Practitioner so as to get approval to sign up. For issues in this regard please reach out to us and contact us here.

 If you have answered NO to the following questions (other than your age), you will then be allowed to proceed to complete the remainder of the intake form to schedule a consultation with Olivia Brown.

 

Step 1 of 2

Self-Screening Information