MATClinics Medical Cannabis Intake Form & Patient Agreement
There are multiple steps before you can be certified for medical cannabis use in Maryland.

Step 1: The first step in being certified for medical cannabis is to register with the MMCC. If you have not already registered, click on the link below and complete the registration process:

Once the MMCC sends you your registration ID, please return to this form and continue the MATClinics process.

Step 2: Make an appointment at MATClinics: 410-220-0720
Step 3: Fill out the Online Intake form here
Step 4: Send your medical history/documentation to MATClinics
Step 5: Meet with your MATClinics provider to assess whether you are an appropriate candidate for medical cannabis
Step 6: Receive final approval from the MMCC
Step 7: Each year (or more frequently if required by your provider), you will be required to be re-evaluated

The following form is Step 3 of the process. Please make sure you have completed steps 1 and 2 before you start to fill out the form.

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