Request edit access
JOIN DOCTOR MIDTOWN'S PRESCRIPTION CLUB
CALLING ALL CREATIVES!

We're stoked to invite you to apply for Doctor Midtown's Prescription Club! As a member, you'll get exclusive access to:
  • "Doctor's Orders" - Handpicked selections of our top-selling products to enjoy, showcase, and share with your audience.
  • Opportunities to collaborate with us on future paid partnerships and projects.
  • A chance to be part of a like-minded community that's passionate about cannabis and creative expression.
If you're ready to elevate your content and get hooked up with the best, apply now to join Doctor Midtown's Prescription Club!

How It Works
  1. Apply: Fill out the application form to join our program.
  2. Receive: If selected, you'll receive a curated selection of Dr. Midtown products.
  3. Share: Create and share authentic content showcasing your experience using hashtags #DrMidtown, #DoctorMidtown & #DoctorsOrders
  4. Collaborate: Standout influencers may be considered for future paid collaborations.
Email *
Full Name *
Birth Date *
MM
/
DD
/
YYYY
Email *
Phone Number *
Address (Include apartment number if applicable) *
Instagram Handle & Follower Count *
TikTok Handle & Follower Count
Other Socials *
What Product(s) Are You Interested In?
Notes / Additional Information
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of DRMIDTOWN inc .

Does this form look suspicious? Report