5-STEP CERTIFICATION

STEP ONE

Complete and submit your contact information using the form on this page.

STEP TWO

Wait for a representative from our office to contact you via telephone, confirm your eligibility, and setup an in-person evaluation.

STEP THREE

Submit payment, proper identification, relevant medical records, and copies of any previous state-issued medical marijuana card(s) to us.

STEP FOUR

Appear for your in-person and telemedicine follow-up appointments with the doctor.

STEP FIVE

Submit your complete application, application fee, and physician certification form signed by the doctor to state authorities via either online portal or US Mail. Appear for your telemedicine follow-up appointments.

Application for Certification

By completing this form, you certify that the information you provide and any subsequent documents are true and correct. You also agree that The Sensi Doctor of Osteopathic Medicine PLC, its representatives, and any individuals or entities providing information to The Sensi Doctor of Osteopathic Medicine PLC in good faith shall not be liable, to the fullest extent provided by law, for any act or occasion related to the evaluation or verification.

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Email Address

Phone

(###)

###

####

Do you have medical records?

Do you have health insurance?

Have you had an annual physical within the last year?

How did you hear about us?

Get Certified

5-STEP CERTIFICATION