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Be sure to carefully read and follow all the instructions below. Missed steps will result in postponement of your appointment.

PATIENT INTAKE FORMS

  • Complete our online Patient Intake forms below. NOTE: Red asterisks indicate required fields. Missing any will cause submission problems. Sign and click the submit button.
  • Review the Consent forms, taking care to ensure the consent boxes are checked. Sign and click the submit button.

TIP: Disregard Part B. That section is just for minors.

PROOF OF CONDITION & DRIVERS LICENSE

Before you begin the forms, be prepared to upload a photo of your Florida drivers license and your Proof of Condition (medical records diagnosis). You will not be able to submit the forms with MISSED required fields. The Identity Documents Section is where you will upload the required documents.  If you need more information about acceptable Proof of Condition, return to the previous screen here. DO NOT SUBMIT A DOCUMENT THAT IS NOT READABLE OR TOO SMALL TO VIEW.

TIP: The accepted formats to upload are: jpg, gif, png

TRANSFER PATIENTS: Upload a photo of your medical marijuana card in place of proof of condition.

SCHEDULE YOUR APPOINTMENT

After your forms are submitted and your uploads are complete, you will schedule your appointment. Follow the below guidelines for choosing the correct appointment type.

NEW PATIENTS | Select your preferred location. Then ‘New Patient $10 Groupon Deal‘ service. Don’t see a location in your city? Click on our customer service chatbot for instructions.

TRANSFERS | Transfer Patients are new to our clinic. Select one of the locations designated as ‘New Patients‘ and then the service designated as ‘Transfer $10 Groupon Deal‘.

BEGIN PATIENT INTAKE PROCESS NOW

BE SURE TO FOLLOW ALL THE STEPS. REVIEW THEM AGAIN IF NECESSARY. RED ASTERISKS NEXT TO FIELD NAMES INDICATE REQUIRED FIELDS. ANY OMISSIONS WILL PROHIBIT YOU FROM SUBMITTING YOUR DOCUMENTS. ENTER YOUR FIRST AND LAST NAME IN THE FULL NAME FIELD.

CONTACT US

Chat Bot

Email: [email protected]

HOURS

Monday – Friday  9:00 to 5:00

By Appointment Only – No Walk-ins


HEADQUARTERS

2111 W Swann Avenue

Tampa, FL  33606

REVIEW US

Google Review Link

LOCATIONS

Tampa

Jacksonville

Orlando

Daytona Beach

Melbourne

Sarasota

Click the Chat Bot to connect to a live Operator for other locations.

Latest News

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