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To have medical marijuana delivered to your home or office you must be a qualified patient and a member of our Co-op. To become a member, simply give us the requested information below and once your doctor's approval has been validated we'll send you a password that you'll be able to change.

E-mail Doctor’s name
First Name Dr phone #
Last Name patient care giver
Phone Patient Number
Address CA Driver’s lic. #
City
State
Zip Code
Comments or Questions
 
We will not sell, give or otherwise share any information supplied herein to any third party. It is for internal use only related to providing you our services.