Prepare For Your Visit Instructions & Intake Forms
Certification Visits Medical Card Services
Thank you for choosing The AC Clinics to help you with your Medical Cannabis Certification! Please follow the steps below to make your intake process as seamless as possible.
Step 1: Download and fill out the Intake Packet below (to be filled out yearly). Fill out the Release of Information with your personal information, as well as the contact information of your primary care provider or primary care clinic so that we can request and verify your medical records. Grant us permission to fax this form by initialing, signing and dating this form where indicated.
Next, fill out the Health History Questionnaire, review the Notice of Privacy Practices, and sign the Release of Liability form.
If you do not have a primary care provider to request records from, please indicate this in the designated field at scheduling.
Step 2: Schedule Your Visitand upload your completed Intake Packet into the designated field at scheduling. Uploading your packet helps our providers better prepare for your visit. However, if you are unable to download and fill out the Patient Intake forms ahead of time, please arrive to your appointment 15-30 minutes early to fill out any indicated paperwork when you arrive. You can also fax or bring your completed forms with you to your visit.
Step 3: Review the medical cannabis regulations and application process in your state(s).