Please provide the following information:

If Answered "Medical conditions of the same kind or class" or "Other," Please Select Below. 

PAYMENT INFORMATION

*Note: Your credit card will not be charged until your appointment is confirmed. Please allow at least 24 hours to be contacted by our staff. 

APPOINTMENT TIMES

Please note, this is only a preferred appointment time. This does not guarantee the selected appointment time. Our Staff will reach out to confirm the selected time or let you know what else is available. 

Please note: mmj application assistance is an additional $25 fee. If you choose "yes," the online application will be completed by us with your consent. This is optional.

CANCELLATION POLICY

We strive to deliver the best possible service to our patients. If you wish to cancel your appointment, we require a minimum of 48-hours notice. If you cancel your appointment <48 hours of your designated appt time/no show, there is a $50 fee.