Register Prior to Your First Visit

GET A JUMP on Things

Exciting news! We have several soft opening times coming up before our Grand Opening on November 17th! Our database is set up to enroll patients. If you'd like to avoid the lines during our first month of operation, you may use this form to pre-register in our system. Our website is secure and this information is required by the MMCC for us to be able to serve you. Additionally, those of you who pre-register will receive text messages letting you know when we are open prior to the 17th.

Name *
Name
Address *
Address
Phone *
Phone
Date of Birth *
Date of Birth
Gender *
I have an MMCC Card *
MMCC Patient ID Expiration Date
MMCC Patient ID Expiration Date
A doctor has recommended cannabis for me. *
This field is applicable if you are a minor or have a caregiver that helps facilitate the purchase of your medical cannabis.