Email: doctor@artemisnymedical.com

Telephone: (914) 200-4160

You are just one step away from your certification.

Please add your details below. Once completed one of our doctors will contact you in 1-2 bussiness days.

Are you a NY resident and have a valid ID?*
YesNo
Are you 18 years of age or older?*
YesNo
What condition do you have?* Description of conditions
NeuropathyChronic PainPTSDCancerSpasticityMultiple SclerosisParkinson'sHuntigton'sHIV/AidsEpilepsyALSIBDNot sureOther
Pleas specify "other"
Do you have documentation from any doctor in the past stating you have that medical condition?*
YesNoI do not have a medical condition approved for medical marijuana
Have you ever been convicted of drug trafficking?*
YesNo
Have you ever attempted suicide?*
YesNo
Have you ever been diagnosed with psychosis or schizophrenia?*
YesNo
Additional information