Prescription FormsCanniMed Medical Cannabis
You may legally obtain and use a designated amount of dried medical marijuana as recommended by your health care provider following the Access to Cannabis for Medical Purposes Regulations (ACMPR) governed by Health Canada. Please use these three easy steps to complete your registration with CanniMed. If you have any questions during your application contact us toll free at 1-855-787-1577 or via email at firstname.lastname@example.org for assistance.
STEP 1: EITHER FILL OUT THE ONLINE FORMONLINE REGISTRATION APPLICATION FORM
OR SELECT AND DOWNLOAD YOUR REGISTRATION APPLICATION FORM
Forms can be filled out on your computer and then printed or they can be printed and then filled in by hand. CanniMed also accepts Health Canada’s forms and forms from other licensed producers. If you don’t have access to a computer, CanniMed would be pleased to mail the forms to you.
Please click on the form (A, B or C) that is applicable to you to download and fill out.
If you have a residence.
If you have no permanent residence.
If your healthcare practitioner is receiving your product for you at their office.
SEND IN ALL COMPLETED FORMS
A copy of form A, B, or C is acceptable. They may be emailed (photo or scan), faxed or sent by mail or courier to CanniMed. The Medical Document may also be submitted by fax, but to be accepted "Part 4 – Fax authorization" of the form must be initialed by the physician and the fax must be sent from the doctor's medical office. If your doctor has given you the Medical Document to submit, you must send the original document with your doctor's ink signature to CanniMed by mail or courier. Contact CanniMed for a free, postage paid, pre-addressed envelope for your convenience.
1 Plant Technology Road
Box 19A, RR#5
Canada, S7K 3J8
STEP 2: DOWNLOAD MEDICAL DOCUMENT TO BE FILLED OUT BY YOUR HEALTH CARE PRACTITIONER
The Medical Document specifies the dosage and which products may be used. Similar to a prescription, it is completed by your health care practitioner. The health care practitioner may be a physician, surgeon or a nurse practitioner.