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Get a Florida (FL) Medical Marijuana Card

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1 (800) 646 - 4189

HOME
ABOUT
APPLY NOW

Get a Florida (FL) Medical Marijuana Card

Get a Georgia (GA) Medical Marijuana Card
CONTACT
LOG IN/REGISTER

Get a Georgia (GA) Medical Marijuana Card

How do I get started?

You verify that you have an approved condition or symptoms similar to an approved condition, and then submit your Medical Marijuana Certification Request & Record Release Form.

What are the qualifying medical diseases?

Cancer, Epilepsy, Glaucoma, HIV/AIDS, PTSD (post-traumatic stress disorder), Amyotrophic Lateral Sclerosis (ALS), Crohn’s Disease, Parkinson’s Disease, Multiple Sclerosis (MS), Medical conditions of the same kind or class as the conditions that qualify or that are comparable to the ones listed; a terminal condition diagnosed by a physician; chronic nonmalignant pain caused by a qualifying medical condition

Who is eligible for the Low THC Oil Registry Card?

There are 3 categories of persons who may apply for the card: 1) an adult who has one or more of the qualified diseases; 2) legal guardians of an adult who has one or more of the qualified diseases; and 3) parents or legal guardians of a minor child who has one or more of the qualified diseases.

How long will it take to get my card?

Typical turnaround from the time you schedule your appointment with us to receiving your physical card is 2-4 weeks.

What types of medical marijuana products can I buy at Georgia dispensaries?

Georgia only permits the sale of low THC oil up to 20 fluid ounces per patient. If a medical cannabis card holder is caught buying/using flowers, edibles, or a pen, they are not exempt from state or federal charges.

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Apply for the Georgia Medical Cannabis Card:
Application Requirements, Instructions, & Fees

Make sure you have a qualifying illness and submit your Medical Marijuana Certification Request & Record Release Form on our website.
Once completed, you will be redirected to the appropriate fee page to complete your application and request your appointment. Based on your selections in the form, you will be taken to one of the following fee pages after submission:
- Initial Comprehensive Medical Consultation ($199.00)
- Recertification Medical Evaluation ($125.00)
- Once at the checkout page, you will have the option of paying now (credit/debit, cash App, Zelle) or later (cash) at your appointment.
A physician will contact you within 24 hours to confirm your eligibility and appointment time. Your confirmation email will also include a link with information to begin your state application if you wish to do so while you wait.
Consult with the doctor to evaluate your ailments and discuss any questions you may have about medical marijuana treatment.
Once approved, you will sign a waiver form and a physician certification form for medical marijuana. These forms will be electronically sent to the Georgia Department of Public Health, where they will be reviewed, and your Low THC Oil Registry Card will be created.
A representative from the Office of Vital Records will contact you, and you will then select the Public Health Office from which you would like to pick up your card.
You will need to renew your card every two years by seeing a licensed physician again. Georgia charges a $25.00 registration fee which keeps the card valid for two years.

Medical Marijuana Certification Request & Record Release Form

Already Completed this Form? Skip to Schedule & Pay

To begin the process of obtaining a medical marijuana card, you must first confirm that you have been diagnosed with a qualifying condition. Please complete the form below so that our physician can request a copy of your records. After submitting the form, you will be redirected to the next step.

1Your Information

2Form Information

3Agreements & Authorizations

4Signatures

Your Name *

First

Last

Your Email Address *

Your Phone #

Is this a renewal? *

If this is your first medical card in Georgia, click “No”.

GEORGIA HIPAA COMPLIANT AUTHORIZATION FOR THE RELEASE OF PATIENT INFORMATION PURSUANT TO 45 CFR 164.508

TO: *

Name of Healthcare Provider/Physician/Facility/Medicare Contractor

Doctor's Office/Facility Address *

Address Line 1

City

State

Zip Code

RE: *

First

Last

Patient’s Name

Date of Birth *

Patient’s Date of Birth

Social Security Number *

Patient’s Social Security Number

I authorize and request the disclosure of all protected information for the purpose of review and evaluation in connection with a legal claim. I expressly request that the designated record custodian of all covered entities under HIPAA identified above disclose full and complete protected medical information including the following: *

All medical records, meaning every page in my record, including but not limited to: office notes, face sheets, history and physical, consultation notes, inpatient, outpatient and emergency room treatment, all clinical charts, r ports, order sheets, progress notes, nurse’s notes, social worker records, clinic records, treatment plans, admission records, discharge summaries, requests for and reports of consultations, documents, correspondence, test results, statements, questionnaires/histories, correspondence, photographs, videotapes, telephone messages, and records received by other medical providers.
All physical, occupational and rehab requests, consultations and progress notes
All disability, Medicaid or Medicare records including claim forms and record of denial of benefits.
All employment, personnel or wage records.
All autopsy, laboratory, histology, cytology, pathology, immunohistochemistry records and specimens; radiology records and films including CT scan, MRI, MRA, EMG, bone scan, myleogram; nerve conduction study, echocardiogram and cardiac catheterization results, videos/CDs/films/reels and reports.
All pharmacy/prescription records including NDC numbers and drug information handouts/monographs.
All billing records including all statements, insurance claim forms, itemized bills, and records of billing to third party payers and payment or denial of benefits for the period defined below.

Release From Date: *

Release To Date: *

I understand the information to be released or disclosed may include information relating to sexually transmitted diseases, acquired immunodeficiency syndrome (AIDS), or human Page 1 of 2 immunodeficiency virus (HIV), and alcohol and drug abuse. I authorize the release or disclosure of this type of information. *

This protected health information is disclosed for the following purposes: *

Please enter a reason for the disclosure of this information, .e.g. to confirm eligibility to obtain a medical marijuana card

Information Released To:

Healing Herbs Medical Marijuana Clinic, LLC
4426 Austell Rd.,
Austell, GA 30106
info@healingherbsclinic.com
Phone: 1 (800) 646 – 4189

I understand the following:

See CFR §164.508(c)(2)(i-iii)

I have a right to revoke this authorization in writing at any time, except to the extent information has been released in reliance upon this authorization. *

I have a right to revoke this authorization in writing at any time, except to the extent information has been released in reliance upon this authorization.

The information released in response to this authorization may be re-disclosed to other parties *

The information released in response to this authorization may be re-disclosed to other parties

My treatment or payment for my treatment cannot be conditioned on the signing of this authorization. *

My treatment or payment for my treatment cannot be conditioned on the signing of this authorization.

Any facsimile, copy or photocopy of the authorization shall authorize you to release the records requested herein. This authorization shall be in force and effect until two years from date of execution at which time this authorization expires *

Any facsimile, copy or photocopy of the authorization shall authorize you to release the records requested herein. This authorization shall be in force and effect until two years from date of execution at which time this authorization expires

Signature of Patient or Legally Authorized Representative *

(See 45CFR § 164.508(c)(1)(vi))

Name and Relationship of Legally Authorized Representative to Patient

(See 45CFR §164.508(c)(1)(iv))

Witness Signature *

Healing Herbs Medical Marijuana Clinic is a trusted and experienced resource for patients seeking fast and reliable medical marijuana certification in Florida and Georgia.

info@healingherbsclinic.com