Now accepting Telehealth appointments. Schedule a virtual visit.

Patient Forms


 

 

 For your convenience, patient forms are available below. Please complete using one of two options:

  • Print at home and bring to your first appointment

  • Fill out the necessary fields online, save it to your computer, and email as an attachment to illmedcanndoc@gmail.com

 

VA Form 10-10EZ

Benefits Investigation and Enrollment Form

Vivitrol Patient Enrollment Form

HIPAA Authorization for Use or Disclosure of Health Information

Release of Medical information

PTSD Coach

Authorization of Treatment Form 

 

You will find information about our lab testing in the document below:

Lab Testing Information

Our Locations

Choose your preferred location