While this form does not need to be signed, we do want you to read and acknowledge that you have done so.
Be a Florida resident or Snowbird/ Seasonal Resident (Evidence: FL Drivers license, Voter Registration Card or copy of Utility Bill)
Had tried other treatments without success.
Have one of the following or similar medical conditions:
Chronic Muscle Spasms
Positive HIV/ AIDS
Posttraumatic Stress Disorder (PTSD) or Anxiety
Amyotrophic Lateral Sclerosis (ALS)
Terminal Conditions diagnosed by a physician other than the qualifying physician issuing the certification.
*Pregnant woman can be only prescribed Low THC Cannabis.
Other several debilitating medical conditions of the same kind of class or comparable, as determined by the Florida Board of Medicine.
1. After you have filled out all the online forms, confirm via email that we received your submission and contact us if you would like to schedule an appointment at email@example.com.
2. One of our physicians will evaluate a patient with a qualifying condition for low THC or Medical Marijuana.
3. The patient will fill a voluntary, written Informed Consent and Release of Liability during the first appointment.
4. The physician enters the order into the Marijuana Use Registry of the Department of Health. The social security number is required.
5. COSTS for our physician visits (Not covered by any health insurance): Pay online (email us for access code and directions although we prefer cash at time of visit, we will accept check or credit card if necessary)
Initial Evaluation- $250
Depending on your diagnosis and complexity of your health condition(s) our physician may require follow up visits every 70 days – $50-75 depending on length of time needed to work on dosages and current medication lists.
Renewal at 210 days- $199
6. START APPLICATION PROCESS WITH THE MARIJUANA USE REGISTRY (Florida Department of Health) – they require a check for $75. The process can take up to 30 days.
Once you see the Green Palms Health and Wellness Palms physician you will receive an email from the The Office of Medical Marijuana Use. You can fill out the online application. To do this you need to have a Florida drivers license, proof of residency i.e..FPL, lease, FL.bank acct. your method of payment for your online application).
Need help filling out your online application?
OFFICE OF MEDICAL MARIJUANA USE PATIENT HELPLINE:
MAIL APPLICATION: Patient will fill and send the following form as applicable with a $75 application fee, and send it to the Medical Marijuana Department of Use Registry. A Department Health regulating medical marijuana processes. (forms available online, ask us if you have any problems with the link below):
– “Compassionate Use Registry Identification Card Qualified Patient Application” DH8009-OCU-10/2016
– “Compassionate Use Registry Identification card Legal Representative Application” DH8010-OCU-10/2016.
*Patient’s responsibility to submit any changes in name, address, legal representative, lost or stolen card or if no longer have a qualifying medical condition to the Department of Health within 10 days with Change, Replacement or Surrender Request DH8012-OCU-10/2016.
7. The patient may fill the order at any dispensary called Marijuana Treatment Centers.
There will be more treatments centers soon (Updated list on the Florida Health website). We are not affiliated with any of them.
There are approved dispensaries in Florida, most of them do home delivery and deliver statewide. Also some of them give discounts for enrolling in supply programs with them. You can choose the one of your preference. Medical marijuana cannot be mailed. (As June 2017). Although they do set up delivery services for you. Cost and Strains of the products varies per dispensary. Please see our listing and detailed instructions on our website under FLORIDA DISPENSARIES.
In the news:
What You Should Know About Medical Marijuana
– as published on Health and Wellness Magazine in July 2017