


AFTER
4 EASY STEPS
Step One:
Meet Qualifying Medical Conditions
Step Two:
Set An Appointment
Step Three:
Submit Form
Step Four:
Make Your Payment
STEP ONE:
MEET QUALIFYING
MEDICAL CONDITIONS
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Cancer
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Position status for human immunodeficiency virus or acquired immune deficiency syndrome
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Amyotrophic lateral sclerosis
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Parkinson’s disease
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Multiple sclerosis
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Damage to the nervous tissue of the spinal cord with objective neurological indication of intractable spasticity
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Epilepsy
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Neuropathies
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Huntington’s disease
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Crohn’s disease
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Post-traumatic stress disorder
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Intractable seizures
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Sickle cell anemia
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Severe chronic or intractable pain of neuropathic origin or severe chronic or intractable pain
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Terminal illness that is defined as a medical prognosis of life expectancy of approximately one year or less if the illness runs its normal course
STEP TWO:
SCHEDULE AN APPOINTMENT
Note:
Scheduling a visit does not guarantee a card. Documentation rules are strict and you must have prior documentation from a different physician verifying your qualifying medical condition. If you have any questions about this please contact our offices prior to scheduling a visit. I respond in real time from noon-7pm Monday through Friday.
STEP THREE:
SUBMIT FORM
