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Proof of Identity
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Telephone Number (Office Hours)
Reason for the application to use unregistered medication: full description including severity, staging and prognosis where applicable. Example: Chronic Pain - experience major depressive disorder, persistent feelings of sadness, loss of interest, inability to concentrate, sleep disturbances, appetite changes, self-isolation, low self-worth.
Current medication and or treatment for the above diagnosis.
Example: aspirin, ibuprofen, naproxen, Serotonin and norepinephrine.
Section 21 (Medical Cannabis)
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