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Do I Qualify for Medical Marijua Treatment. Fill out Questionnaire and We will contact You. NO INSURANCE COVER THIS SERVICE.
Do you Have Any of the Marijuana Qualifying Conditions for Florida *
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Do you have Medical records supporting diagnosis of any qualifying conditions *
First Name *
Last Name *
Phone Number *
Email *
Preferred Method of Contacting you *
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I understand that to have a confirmed first appointment I will have to make full payment of 100 Dollars. If I am not qualified then the 50% of the deposit will refunded. I further agree that if I qualify to be appropriate for such treatment then I am willing to participate in the membership program of Medical Marijuana treatment program of Craft Clinic (a subsidiary of Craft Behavioral Health). I agree to provide a credit card for auto deduction of 29 dollars a month. This subscription can be cancelled any time however cancellation of subscription or declined payments of credit card will be considered termination of participation in program. I also agree to go through random drug screen. If I am a female of child bearing age I understand I am required to notify if I get pregnant during the course of treatment, as soon as possible. PLEASE NOTE YOU MAY RECEVIE A CALL FROM A PRIVATE NUMBER. *
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