Prescription Forms Banner

Prescription  Forms

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 info@cannimed.com for assistance.

STEP 1: SELECT AND DOWNLOAD YOUR PRESCRIPTION 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.

Cannabis Prescription

If you have a residence.
(most patients use this form)

Health Canada Licensed Cannabis

If you have no permanent residence.
(live in a shelter, hostel, etc.)

Licensed Producer

If your healthcare practitioner is receiving your product for you at their office.

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.

DOWNLOAD MEDICAL DOCUMENT

STEP 3: 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
Saskatoon, SK.
Canada, S7K 3J8

Phone: +1‑855‑787‑1577
Fax: +1-844-231-8929
Email: info@cannimed.com