Individual Medical Cannabis Treatment Plan in Massachusetts

Please choose the various plans below. You may order a complete treatment plan or individual sections that you are interested in purchasing.

These plans are approved and reviewed by our medical staff who are all certified by the Cannabis Control Commission of Massachusetts to approve patients for medical marijuana treatment.

Product Name

Current Modules Available

Patient First Name(Required)

Patient Last Name(Required)

Date of Birth(Required)

Email(Required)

Phone(Required)

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

CONSENT TO CREATE MEDICAL CANNABIS TREATMENT PLAN

By signing below, I consent to allow The Holistic Center to create an individualized cannabis treatment plan based on my medical history and health goals. I understand this may include protected health information and agree to its use and secure storage in compliance with HIPAA regulations.

Signature(Required)

By typing my name below, I agree that this will serve as my electronic signature.

Please list your qualifying medical condition(s):(Required)

Total

Discount Code

Credit Card

Cardholder Name

Card Details

THE HOLlSTIC CENTER’S MEDICAL MARIJUANA TREATMENT PLAN