Home
About Us
Cannabis
Contact
Testimonials
Blog
Pre-register
Patient Log-in
Pre-register
PERSONAL INFORMATION
Name
(required)
Email Address
(valid email required)
Phone
Birth Date
DRIVER LICENSE
ADDRESS:
CITY:
Zip Code
DOCTOR'S INFORMATION
DR. NAME:
DR. PHONE
RECOMMENDATION NUMBER
DATE OF RECOMMENDATION:
DATE OF EXPIRATION:
REFERRALS
REFERRED BY:
WeedMaps
CA NORML
Myspace
Facebook
Online Forum
Other
- If Website - URL:
- If Referrer Patient - Name
- If Referrer Patient - Email:
- If Other - Comments:
membership plan interested in:
White - $0.00
Black - $45.98
Silver - $87.98
Gold - $160.92
Green - $294.26
Diamond -$1057.48
MedCare is no longer delivering medications to patients.
We thank you for choosing MedCare Cooperative for your medication needs in the past
We look forward to providing you with greater service in the future.
medcare@medcare420.com
