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Pre-Qualify

Fill out the following information to begin the process of certification.

* Required

Do you currently have, or have you had a Michigan Medical Marijuana Card? *

Yes
No

Please rate your current pain level. *

	1	2	3	4	5	6	7	8	9	10
No Pain											Extreme Pain

Are you now receiving medical treatment for your pain or discomfort?

Yes
No

Please list medical problems. Dates, Diagnosis, And Other Information.

Current Primary Physician?

When was your last physical examination?

Do you have medical records documenting your symptoms and/or condition?

Yes
No

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PHYSICIAN CERTIFICATION

Re-Certification

~~$100~~ $75
New Certification

~~$150~~ $100

Medical marijuana doctor qualification.

Doctor Certifications

We provide physician recommendations to qualified patients for the medical use of marijuana.

Call Us at (855) DOC-CERT

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