MICHIGAN Intake Form

To complete the Intake Form, please click the link below. Be as specific as you can.
Don't forget to include
  1. Valid Michigan DL or State ID  
  2. Renewal Card if applicable
  3. 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: 

  • Cancer

  • Glaucoma 

  • HIV/AIDS Positive

  • Hepatitis C

  • Nail Patella 

  • Amyotrophic Lateral Sclerosis

  • Crohn’s Disease

  • Agitation of Alzheimer’s Disease

  • Post - Traumatic Stress Disorder

  • Obsessive Compulsive Disorder

  • Arthritis

  • Rheumatoid Arthritis

  • Spinal Cord Injury

  • Colitis

  • Inflammatory Bowel Disease

  • Ulcerative Colitis

  • Parkinson’s Disease

  • Tourette’s Disease

  • Autism

  • Chronic Pain

  • Cerebral Palsy

A chronic or debilitating disease or medical condition or its treatment that produces 1 or more of the following:


  • Cachexia or Wasting Syndrome

  • Severe and Chronic Pain

  • Severe Nausea

  • Seizures (Including but not limited to those characteristic of epilepsy)

  • 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: 

Marijuana Regulatory Agency

Michigan Medical Marijuana Association

Planet Green Trees TV

Komorn Law