Use the Survey below to see if you qualify!

Take our easy qualification survey to see if you qualify for a Medical Marijuana recommendation today!

    Let's start with some basic patient information.

    Please select your medical condition

    My condition affects my everyday life
    1: Not at all2: Half the time3: All the time  
    I have constant pain from my condition
    1: Not at all2: Half the time3: All the time  
    I can not do the things I enjoy because of my condition
    1: Not at all2: Half the time3: All the time  
    I have been prescribed medications with the the possibility of addiction and or adverse side effects
    1: Not at all2: Half the time3: All the time  
    I do not sleep well or at all because of my condition
    1: Not at all2: Half the time3: All the time  
    My condition has impacted my relationship with friends and or loved ones
    1: Not at all2: Half the time3: All the time  
    I have had to alter my life drastically because of my condition
    1: Not at all2: Half the time3: All the time  
    If medical marijuana is able to help with my condition, It would make my quality of life much better
    1: Not at all2: Half the time3: All the time