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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

  • We have a new EMR system. Existing Patients MUST submit new Intake & Consent forms.
  • Complete our online 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 Medical Marijuana Card. The Identity Documents Section is where you will upload the required documents.  Upload the photo of your medical marijuana card in place of the medical records diagnosis.

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

SCHEDULE YOUR APPOINTMENT

After your forms are submitted, schedule your appointment. Follow the below guidelines for choosing the correct appointment type. Recertification appointments are virtual. Be sure to review your appointment confirmation email and instructions.

RECERTIFICATIONS | Select one of the locations designated as ‘Recertifications‘ and then the service designated as ‘Existing Patient‘.

TRANSFERS | Select one of the locations designated as ‘Recertifications‘ and then the service designated as ‘Transfer‘.

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

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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

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LOCATIONS

Tampa

Jacksonville

Orlando

Daytona Beach

Melbourne

Sarasota

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

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