A Caregiver Can Help You to Get Edibles

Complete the Form Below to Get Started

Cannabis Caregiver Request Form

We operate our services under the changing Canadian laws and guidelines of medical cannabis, and our mission includes helping patients in need access to safe and reliable options. We are not mandated to regulate or supervise a persons choice of freedom, and in general we fully support the cannabis healing community as a whole. We would be happy to discuss your unique situation and circumstances. In the case where we have an inability to help directly, we can provide consultation, referrals and recommendations to safe and reputable options.

A caregiver is permitted to grow cannabis on your behalf for medical purposes, and also includes the ability to convert medical marijuana into specific concentrates or edibles. Upon submitting this request, you will be contacted within 24 hours by a caregiver representative that will walk you through the quickest way to get edibles.

Caregiver Application Process Step1

We’d like to start by getting to know you.

Our services includes personalized consultation and guidance. Pardon if we’re getting a bit personal, but we’re only here to assist you. The best way in which we can help you, starts with getting to know you a little better. Please offer some due diligence by connecting with us on social media in any number of the following ways.

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Please Confirm your Declaration and Complete the Following Questions

Declaration

I declare my intention to use edibles is for the purpose to treat one or more medical conditions, and I invoke my right to medicate with products made with cannabis, under the Canadian Charter of Rights and Freedoms as outlined in the Supreme Court of Canada Decision in R. v. Smith. In addition I agree to handle such products responsibly and to keep all medications locked away from children and other persons.

 YES

Confirm Personal Status

Are you a Canadian resident?

 Yes No

Are you at least 19 years of age?

 Yes No

Are you a Military Veteran?

 Yes No

Do you have a valid provincial health card?

 Yes No

Are you presently licensed to use Medical Cannabis?

 Yes No

Do you suffer from any of the following medical conditions?

 ADD Chronic Pain Insomnia ADHD Crohn's Disease Irritable Bowel Syndrome Anxiety Degenerative Diseases MS Arthritis Depression Panic Attacks Asthma Epilepsy Parkinson's Disease Autism Fibromyalgia PTSD Brain Injury Glaucoma Seizure Disorders Cancer Hepatitis C Sleep Disorders Chronic Nausea HIV/AIDS Other (please specify)

Can you list any past or present medications and/or treatments?

Do you happen to have any of the following medical documents?

 Letter of Diagnosis Previous Prescription for Medical Cannabis X-Ray Previous Prescription for Current Ailment MRI Record of Previous Doctors Visit Sympton-Ailment Report NO or Other (fill in box below)

Please specify your primary interests

 Access to Edibles Access to Medical Flower Access to Oils & Concentrates Getting Licensed Other (please specify)

Please indicate your experience with using Cannabis

 Regular Toker Once in a while Only tried it a few times Never tried before Other (please specify)

Please indicate your experience with consuming Edibles

 Familiar taking Edibles Tried once, or few times Never tried before Other (please specify)

Do you know your tolerance level for Edibles?

 10-20mg 40-60mg 75-100mg 150+ I'm not sure Other (please specify)

Do you have experience with dispensaries?

 Prefer buying from a dispensary OK with dispensaries but prefer Health Canada regulated cannabis Will not buy from a dispensary Other (fill in box below)

Contact Information

First Name

Last Name

City or Location

Telephone

Email

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