In order to make your visit faster, we have provided
the following forms.
Download them and print them out on your home printer and fill them out and bring them with you on your appointment day.
- Pre-evaluation patient information questionnaire
- Medical Marijuana patient declaration
- Medical Marijuana acknowledgements, agreements, disclosures and informed consent
- Release of liability
- Affidavit
Authorization for release of medical information.
If you need help getting a copy of your medical records and you have seen a doctor within the last 2 years, you may download our medical release form in P.D.F. format.
When filling out the medical release form, sign, date, and fax (1-619-566-2022) it back to us with as much information as possible. After we receive your completed release form, we will forward this request to your doctor's office.
Obtaining a copy of your medical records from your primary care or treating physician's office is a free service we provide to our patients. Some doctor's office may charge a fee to obtain a copy of the patient's medical records. If this occurs, the patient would be responsible for any fees imposed by the corresponding doctor's office.
If you do not have sufficient medical records at the time of your visit, it is possible that you may not receive a recommendation to use cannabis during your initial visit. The doctor will ask you to come back for a follow up visit, at no additional cost, once your records arrive.
