Patient Forms
Get Your Medical Marijuana Card Today
Book an Appointment
Book an Appointment
Patient Forms
Fill out the below forms to obtain or renew your Medical Marijuana card.
Call us at 239-789-6561 if you have any questions.
Call us at 239-789-6561 if you have any questions.
New Patients:
- Required – New Intake Form
- Required – Authorization to Request Medical Records
- Required (Day of Visit) – Medical Marijuana Consent Form
Follow-up Visits:
- Required (Day of Visit) – Medical Marijuana Consent Form
- Required (Follow-up only) – Follow up Form
Follow-up Assessments:
How It Works

Pre - Qualify
Do you have one of the listed QUALIFYING CONDITIONS or a similar condition? If so, please call and schedule an online appointment.

Online Evaluation
Schedule an online consultation at a time convenient for you, followed by a brief in-person visit at one of our two locations in southwest Florida.

Get Approved
If you qualify, our professional, licensed staff will help you apply to get your medical marijuana card. See new patient guide for more info.
Our Locations
6150 Diamond Centre Ct Suite #700-2, Fort Myers, FL 33912, USA
260 Beth Stacey Blvd, Suite #220, Lehigh Acres, FL 33936