PreVerify

For pre-verification of your doctors recommendation and residential status please fill out the form below.

Name *

First

Last

CA Identification card number *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Phone Number *

Email *

SCAN and UPLOAD doctors recommendation here: *

Max file size: 20MB

SCAN and UPLOAD California Identification here: *

Max file size: 20MB

Have you visited Otherside Health Center before? *

Yes No

Comment *

I am interested in *

Coming to OHM's location Delivery Both delivery and coming into OHM's location

What do you use cannabis to treat? *

How did you hear about us? *

Comment *

Submit