Patient Update Page
Patient Prefilled Update Page
First Name*:
Last Name*:
Email*:
Medicine Prescribed:
Indica
Sativa
Hybrid
Condition for prescribed treatment:
Physical
Psychological
Pain
How effective has your medication been?:
(Select one only)
None
Somewhat
Satisfactory
Very Good
Excellent
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What would make your stay with us the best it could be?
A newsletter would be nice
Please note: * Denotes required field.