Medical Cannabis Eligibility

Your Information

Name(Required)

First name

Last Name(Required)

Last name

Date of birth(Required)

Contact Email(Required)

Telephone (+44)(Required)

Hidden

Maiden Name

Address

Lookup Your Postcode

Home Address(Required)

City(Required)

Post Code(Required)

Country / Region(Required)

Address

Contact Preferences

Reason for treatment(Required)

Have you previously tried at least two other licensed medicines for your condition, as prescribed by your GP or other specialist?(Required)

Yes

Have you ever been diagnosed with Schizophrenia or Psychosis?(Required)

Yes

Are you transitioning from another medical cannabis clinic?(Required)

Yes

Are you a veteran or currently claiming benefits?(Required)

Yes

Thank you for taking the time to complete our eligibility questionnaire.

Unfortunately, due to one or more reasons we are not able to progress with booking a consultation for you, as currently you are an ineligible patient for medical cannabis.

At Mamedica we recommend those that are ineligible to consider completing this eligibility questionnaire again if their medical situation changes. If you have any queries on this, feel free to contact us here.

Contact Clinic

Check your eligibility

Your Information

Address

Address

Contact Preferences

Your GP's Information