PATIENT Forms

Medical Records Release Form

If you would like us to request your medical records for you.

Medical Records Release for Homegrown

If you would like to request your records from your appointment with Homegrown.

HIPAA Notice of Privacy 

Because our office observes all state and federal HIPAA laws.

Personal Production License Application

If you are an active cardholder and want to grow your own plants

Caregiver Application

If you would like to assign a caregiver

Medical Cannabis Program Fact Sheet

From the Dept of Health's website

New Patient Health Intake with PTSD Self-Assessment

If you are applying for your card for the first time and are applying under PTSD

New Patient Health Intake for Physical Conditions

If you are applying for your card for the first time and are applying under a physical condition

New Patient Health Intake with Opioid Use Disorder Self-Assessment

If you are applying for your card for the first time and are applying under Opioid Use Disorder

Renewing Patient Health Intake

If you are renewing your card

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