Patient Referral Forms

Patient Referral Forms 2018-03-19T15:49:36+00:00

If you think your patient may benefit from prescription cannabinoids or medical cannabis, 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
Download Ontario Referral Form
Online Patient Referral Form
Online Self-referral Sleep Aid Form
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