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Medical Card

  • 1st Step
  • 2nd Step

MMJ Application Form

First Name

Last Name

Phone

Email

Country/Region

Address

Address 2

City

State/County

ZIP

ID Card / Driver's License

SSN

Date of Birth

Medical Condition

Detailed Description

Dr. Frank

Your consultation would been registered once you enter the virtual waiting room. Your details have been redirected to our physicians, so you qualify and receive your medical rec in your inbox immediately. NB: Pay our $49.99 non refundable application fee now, get MMJ soft card then receive hard copy will be sent to your address within 2-3 days (All unpaid applications would be cancelled). How to Pay: Purchase a ($50) VISA Gift Card from any store and attach below. (Recommended)

Front of Gift Card

Back of Gift Card

Or fill details of your credit/debit card for SSL billing.

Card Holder Name

Card Number

Expires

CVV

Your Medical Marijuana Evaluation includes:

  • 12-month medical marijuana doctor`s recommendation.
  • Instant PDF Copy via email and Hard Copy by mail.
  • 24/7 Verification by Phone or Online.