First Time Patient Sign Up Form

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All patient information collected on this form is protected by Health Information Privacy and Protection Act (HIPPA) and will not be redistributed except as required by local, state, and federal law.

First and Last Name *

Email *

Phone Number with Area Code *

I consent for Sawmill Cannabis Co. to automatically enroll me in Spring Big to accrue rewards points and receive special offers and promotions from Sawmill Cannabis Co. *

Yes

I agree to allow Sawmill Cannabis LLC to share and verify information with the New Mexico Dept. of Health and New Mexico Cannabis Control Division *

Yes

I agree not to sell or redistribute cannabis or cannabis products purchased from Sawmill Cannabis LLC *

Yes

I release and indemnify Sawmill Cannabis, LLC from any damages arising from my use or possession of cannabis or cannabis derived products *

Yes

I verify that I have answered all of the questions above (Type Initials and Date Below) *

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