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CannaCauses Foundation

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 Cannabis Therapy™ Consultation Request
  “Everyone deserves the medicine they need” 

This form works best on the latest versions Google Chrome and Safari web browsers!

Consultation Form New - Basic Info

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Full Name*
Primary Diagnosis*
Date of Diagnosis*
Address*

After clicking submit, you will be redirected to complete the full length consultation form. It will take roughly 30 minutes to complete, and you will need your medications, diagnoses, and cannabis usage information at hand.
Once this form is submitted, you will receive an email with a link to the full length form. If you are not ready to complete the form right now, you can come back to it later using that link.

This field is for validation purposes and should be left unchanged.
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Our Mission

To emphasize relations that result in the effective growth and responsible use of cannabis and its therapeutic benefits. To serve as a credible source for research, education, and information for anyone seeking trust, credibility, and integrity above all. To pay it forward by supporting generally charitable activities that benefit the most vulnerable and heroic among us.

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