Amend a Patient Registration with WeedMD

Clients of WeedMD who need to make changes to their registration information can do so by filling out the necessary section(s) of the Client Amendment Form below.

To complete this form you’ll need your Client ID Number.  If you don’t have your unique identifier, or you aren’t sure what this is, please contact our Client Services Team.

WEEDMD CLIENT AMENDMENT FORM


YOUR BASIC INFORMATION

YOUR CONTACT INFORMATION

YOUR MAILING AND SHIPPING INFORMATION

INDIVIDUAL RESPONSIBLE FOR THE APPLICANT

HEALTHCARE PRACTITIONER

WE JUST NEED YOU TO CONFIRM A FEW THINGS:

  • The Applicant ordinarily resides in Canada.
  • The information in the Application and the Medical Document is correct and complete.
  • The Medical Document is not being used to seek or obtain fresh or dried marihuana or cannabis oil from another source.
  • The original of the Medical Document is provided in support of the Application.
  • The Applicant will use fresh or dried marihuana or cannabis oil for their own purposes.

CLIENT SIGNATURE

WELCOME

Are you the age of majority in your province?
(19+, or 18+ in Alberta and Quebec)

   

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