Request edit access
Request form: Trusted Source Digital Sign, "Why Shop Here?" 
MCA developed this digital sign in response to requests from dispensaries to place "Cannabis Trusted Source" information inside their businesses. The digital sign is an animated .mp4 file and intended for use only on TV screens/monitors inside licensed dispensaries. If you'd like to receive this electronic file, please complete this form. Requests will be reviewed and fulfilled on a weekly basis. Questions? publichealth.mca@maryland.gov
Sign in to Google to save your progress. Learn more
Digital MP4 Video (final image displayed below)
For TV screens/monitors inside your dispensary. The .mp4 electronic file is a 15-second animated video with each checked line appearing individually. There is no audio. 
Dispensary name (storefront name) *
Dispensary license # (DA-xx-xxxxx) *
Requestor's full name. Note: requests may be made by the dispensary owner, manager or other designated POC, if applicable.  *
Requestor's email address *
Terms of use:
- Digital display is for use on TV screens/monitors inside licensed dispensaries only.
- The file from MCA may not be resized or altered in any way.
- Sharing or altering the file or other misuse is cause for licensee discipline.

Do you agree to these terms?
*
Is there any additional information you would like to provide to MCA about this request?
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of State of Maryland.

Does this form look suspicious? Report