Book Appointment | Good Canna Now

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Are you a New or Renewing patient for Medical Cannabis?*

Renew New

Are you physically waiting at the dispensary? *

Yes No

Personal Information You selected a booking for Louisiana Certification by Next Available Provider. Providing accurate personal information is essential to ensure your certification process goes smoothly.

First Name*

Middle Initial

Last Name*

Full Name must match your state ID Card: such as a drivers license or you may be rejected at your dispensary

Email*

Confirm Email*

Enter a valid email to receive your approval

Phone Number*

Confirm Phone Number*

Please disable call blockers/filters to receive your appointment call

Date of birth*

Suffix (Jr, Sr, I, II, III, IV)

Drivers License / ID Number

Address Please ensure the address you provide matches the one on your state ID to avoid any delays or discrepancies during the certification process.

Street Address*

City*

State*

Zip Code*

Apt, Unit, Lot, etc

Patient Intake Form Accurate health information is crucial for the doctor to make informed and effective medical decisions regarding your care.