What province or territory are you located in?(Required)AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukonAre you a new patient or are you renewing?(Required) New Patient Renewal Name(Required) First Last Email(Required) Are you over 18?(Required) Yes No How much do you spend on medicinal cannabis per month? (flower, oils, gelcaps, edibles, creams etc.)(Required) $10-$100 $101-$200 $201-$300 $300+
