Registration Through Dispensary

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1Welcome to the Online Medi Cards (MMJ) Certification System

2MMJ Certification Form Makes It Easy And Reliable

3MMJ Certification System The Final Step

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Patient Name *

First

Middle

Last

Phone *

To Apply, Select Your State *

Email *

Gender *

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Enter Your Driver's License or State ID NUMBER *

Enter Your Date Of Birth *

Address (please include apartment / suite number if any) *

Address Line 1

City

State

Zip Code

QUALIFYING CONDITIONS

Arthritis
Glaucoma
Persistent Muscle Spasm
COVID-19
Cancer
Crohn's Disease
Multiple Sclerosis
Cachexia
HIV or AIDS
Seizures
Anorexia
Alzheimer's Disease
PTSD
Parkinson's Disease
Chronic Pain
Migraine
Severe Nausea
Autism Spectrum Disorder
Amyotrophic Lateral Sclerosis
Anxiety
Other

Do you struggle with focus or exhibit signs of attention deficit disorder?

Do You WISH to Get Notifications for RENEWAL and other PROMTIONAL Offers From Online Medi Cards through TEXT Messages?

UPLOAD DRIVER'S LICENSE OR STATE ID *

Click or drag a file to this area to upload.

You must submit a government-issued photo ID card, such as a driver's license or passport, in order to prove your legal name and identity.

PATIENT'S SIGNATURE *

(Telehealth means the mode of delivering health care services and public health via information and communication technologies to facilitate the diagnosis, consultation, treatment, education, care management, and self-management of a patient's health care.)

Please Select a Plan For Your Selected STATE *

California Recommendation - $39.99
CA Recommendation & Physical Card - $59.99

Coupon Code (Optional)

Order Summary

$0.00

Please Check Your Total Amount then Proceed Check Out

Card Details *

Card Number

Expiration

Security Code

Note: The Payment Will Show Up Lunar Pro Corp on Your Bank Statement.