In-Office. New patient. Card renewal.
Completion time: 10-14 minutes
This form is for:
- Patients new to our practice
- FL med card renewal and doctor change
Protected Health Information (PHI)
The personal information we collect is necessary for you to apply to the State Registry. We upload required identifying data to the Florida state OMMU registry to get your marijuana card. This info is considered PHI and although we store it on our local computer, we use it solely for the purposes of this business transaction. We do not share, sell, or give access to any third party, nor do we send it to, or store it, in the 'cloud'. Our privacy notice is below.