MICHIGAN Intake Form
To complete the Intake Form, please click the link below. Be as specific as you can.
Don't forget to include
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Valid Michigan DL or State ID
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Renewal Card if applicable
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Medical Records if available
Before your appointment please be sure to download the free zoom app on your phone or tablet before your appointment.
Click Here ---> Intake Form
Michigan Qualifying Conditions
The State of Michigan has established a list of approved conditions to qualify for the Medical Marijuana Program. To qualify for use of medical marijuana, a patient must be suffering from one or more of the following debilitating conditions:
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Cancer
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Glaucoma
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HIV/AIDS Positive
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Hepatitis C
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Nail Patella
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Amyotrophic Lateral Sclerosis
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Crohn’s Disease
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Agitation of Alzheimer’s Disease
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Post - Traumatic Stress Disorder
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Obsessive Compulsive Disorder
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Arthritis
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Rheumatoid Arthritis
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Spinal Cord Injury
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Colitis
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Inflammatory Bowel Disease
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Ulcerative Colitis
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Parkinson’s Disease
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Tourette’s Disease
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Autism
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Chronic Pain
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Cerebral Palsy
A chronic or debilitating disease or medical condition or its treatment that produces 1 or more of the following:
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Cachexia or Wasting Syndrome
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Severe and Chronic Pain
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Severe Nausea
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Seizures (Including but not limited to those characteristic of epilepsy)
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Severe and Persistent Muscle Spasms (Including but not limited to those characteristic of multiple sclerosis)
To learn more, explore some of Michigan's Medical Marijuana Resources: