Patient Assessment Form

The Panday Group Medical Cannabis Authorization Form & Agreement

Welcome to The Panday Group Medical Consultancy powered by our Online Medical Cannabis Prescription Services portal. You are about to fill out the Medical Cannabis Patient Assessment Form. This form will be used to collect your info as well as your personal health info. All information is securely stored and is not shared with anyone outside The Panday Group network. **Average Time to Complete Form Approximately 15 minutes.
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  • Please write your First, Middle and Last Name as they appear on your ID
  • Please choose the requested service.
  • Please provide your current place of contact in the fields below
  • Please place the best number our staff can get a hold of you.
  • The Panday Group health practitioners DO NOT bill OHIP
  • Drop files here or
    Accepted file types: jpg, jpeg, gif, png, pdf.
    Allowed files jpg, jpeg, gif, png, pdf
  • Drop files here or
    Accepted file types: jpg, jpeg, gif, png, pdf.
    Allowed files jpg, jpeg, gif, png, pdf
  • Date MM/DD/YEARTime: Example 10 AM 
    Provide 3 Options - Click the + to add dates and timings. Call can be between 10 AM - 10 PM - Monday to Saturday All timings are Eastern Standard Time (EST)
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