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Online Verification

Please complete and submit the secure form below to begin our verification process. If you need assistance, please contact us.

Fields marked * are very important and should be completed if possible. Providing us with the information requested below will help us expedite your verfication.

Patient Information:

* Full Name:
* Driver's License #:
* Street Address:
* City:
* Zip Code:
* Date of Birth:
* Phone Number:
* Email Address:

Doctor & Prescription Information:

* Name of Doctor:
* Phone Number:
* License Number:
* Patient ID Number:
* Issue Date:
* Expiration Date:

Preferred Contact Method:

Phone

Email

OUR VERIFICATION PROCESS

So how does the verification process work? Simply fill out the form on this page and click the submit button. Once we receive your information we contact our discrete and confidential verification service and get an instant response. We will then contact you by your method of choice to let you know that you have been verified. After that it's just a matter of choosing the medicine you wish to have delivered.

Confidentiality: We understand the importance of keeping your information private. You can rest assured that we will not share you personal information with any outside sources and only key trusted personell are involved in the process.

Security: Notice the lock icon or https:// in your browsers address bar? That means your information is safe as it travels across the internet, invisible to anyone who would try to intercept it. Do the delivery services you currently order through have this feature?

SEE US ON WEEDMAPS.COM

CURRENT SPECIALS

FREE delivery for orders $35 or more! Under $35 a $5 charge may occur

First time patient special FREE Pre-roll with a $40 donation or FREE edible of your choice with any size donation.

Refer a friend special FREE edible of your choice with any size donation

Vets, senior citizens, and seriously ill patient discount: 10% off select strains or a free edible with every donation.