Chicago Compassion Club


Call Us Today at (773) 906-5339
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Schedule an Appointment For Your Medical Cannabis Card

TO SCHEDULE AN APPOINTMENT PLEASE COMPLETE THE FORM BELOW.
WE WILL CONFIRM YOUR APPOINTMENT WITHIN 5 WORKING DAYS.

IN ORDER TO SCHEDULE AN APPOINTMENT
I CERTIFY THE FOLLOWING INFORMATION IS TRUE
I have been diagnosed with one or more of the conditions approved by the State of Illinois Medical Marijuana Division. I will have the required records in my possession when I arrive at your clinic. These records include:

1. A diagnosis by my doctor(s) indicating that I have one or more of the approved conditions.

2. My doctor’s name does appear on the records.

3. I can prove that I have been treated by my doctor for one year or longer either by dates on the records or by a letter from my doctor indicating this to be true.
TEST


Have Questions?
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Give Us a Call 24/7

Call (773) 906-5339
Fax (773) 906-5537

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