PATIENT PRE-VERIFICATION 

To Pre-Verify medical marijuana recommendations with Emerald Perspectives,
​certified medical marijuana patients must completely and accurately fill out the form below.
Please have your recommendation and driver's license available to upload (ie: take a photo, scan it in, etc).
BE SURE TO HIT BOTH SUBMIT BUTTONS!!! THE BOTTOM ONE ONLY SUBMITS THE AGREEMENT, BE SURE TO SUBMIT ID/REC TOO!!!

    Please complete the form below
    Max file size: 20MB
    Max file size: 20MB

*please read the patient member terms & conditions below
​*fill out the date & name sections
*click on the button to agree to the terms & conditions

Did you click the first submit button? Scroll up to check; if your info is still there, click "submit"
**you may also print out the Patient Member Terms & Conditions, sign them, and hand them in with your order.