Medical Marijuana Council - Marijuana Information
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To get your medical marijuana card, become a caregiver, get help growing, or get help finding a caregiver, fill out the form below. All Information is kept private & confidential unless permission is given.
Name
What City Are you In?
Who Referred You?
Email
I Want To Get My Medical Marijuana Card
Yes
No
Add me to your Newsletter which provides Recipes, Discounts, Grow Tips, and a "Patient Helping Patients" Section
Yes
No
I Am An Approved Medical Marijuana Patient who is looking for a Caregiver or Grower
Yes
No
If "yes" - The Medical Marijuana Council has permission to share my information.
I Am an Approved Patient who Needs Growing Help and Consulting
Yes
No
If "yes" - The Medical Marijuana Council has permission to share my information.
Telephone
The Telephone Number Listed Above Can Receive Text Notices
Yes
No
Additional Telephone
The Telephone Number Listed Above Can Receive Text Notices
Yes
No
Where Did You Hear About Us? Please be specific.
I Am a Caregiver / Grower Looking for a Patient in Need
Yes
No
If "yes" - you have permission to share my information.
Best day of week and time of day to schedule you for a Medical Marijuana Certification? We Do accept Walk-ins, however we want to keep your wait as short as possible.
Message
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Marijuana Patent 6630507
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