What We Require for your Initial Appointment




Completed in-take packet that you may complete on-line. This form can also be downloaded using the buttons below.


Clear color copy of your ID, which you can email or fax to us or send to our HIPAA protected cell phone number: 318-344-4890 and please indicate which clinic is to receive the ID.


Medical Records: Confirming your debilitating medical condition.

Additionally, our physicians are available for a consultation regarding your medical condition and/or a records review prior to your initial visit to save you any
inconvenience of an appointment for a non-qualifying condition. There is no guarantee of a recommendation before the physician evaluates you and we guarantee you a full refund if you do not qualify for services at the initial appointment.

Fees

Please be aware that there are no refunds available once a patient has begun services.

New Patient Fees

Initial payment of $99, this is a 100% NON-REFUNDABLE FEE.

Established Patient Fees

If you choose to continue treatment with us, you may receive up to 12 months of medication on your recommendation. The fee for a 6-month recommendation is $200. You may also choose to pay this in installments.


Please call us if there are any questions about our fee structure at 318-227-4088. All treatment with Medicinal Marijuana will be an out of pocket expense. Insurance, Medicaid/Medicare do not cover this type of treatment at this time. If you'd like to schedule an appointment with us, you can contact our offices.

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