Patient Referral Forms

Patient Referral Forms 2017-12-04T22:37:02+00:00

If you think your patient may benefit from prescription cannabinoids or medical marijuana, please download and complete the Patient Referral Form below. Completed forms can be faxed to CMClinic at 1-844-320-9652.

Download Atlantic Referral Form
Download BC Referral Form
Download Western Canada Referral Form
Download French Referral Form
Download Ontario Referral Form
Online Patient Referral Form
Online Self-referral Sleep Aid Form
Newsletter Signup