Check if I'm EligibleStep 1 of 333%Check if you're eligible for medical cannabisYour Full Name(Required) First Name Last Name Your Email Address(Required) Email Address Confirm Email Address Mobile Number(Required)Please enter your mobile number without any spaces or country codesDate of Birth(Required) DD slash MM slash YYYY Medical Condition(Required) ADHD Agoraphobia Anxiety Appetite Disorders Arthritis Autistic Spectrum Disorder Back and Neck Pain Bipolar Bladder Pain Cancer Pain and Nausea Chrohn’s Disease or Colitis Pain Chronic and long term pain Chronic Fatigue Syndrome (CFS) Cluster Headaches Complex regional pain syndrome Depression Dermatology DVT Ehlers-Danlos Syndrome (EDS) Epilepsy Endometriosis Female gynaecological pain Fibromyaalgia Irritable Bowel Syndrome (IBS) Migraine Multiple Sclerosis pain and muscle spasm Nerve Pain OCD Osteoporosis Pakinson’s disease Personality Disorder Phantom Limb Pain Post Traumatic stress disorder (PTSD) Sciatica Scoliosis Sleep Disorders Spondylolisthesis The Menopause Thalasemia Major Blood Disorder Tinnitus Tourette Syndrome Trigeminal Neuralgia Other Medical ConditionOther Medical Condition(Required)Please provide further details of medical conditionPrescribed Medicines / Treatments(Required) Alfentanil Alprazolam Amitriptyline Atomoxetine Azathioprine Buprenorphine Bupropion Citalopram Clonazepam Codeine Codeine Phosphate Co-Codamol (30/500) Dexamfetamine Diazepam Diclofenac Dihydrocodeine Fentanyl Fluoxetine Fluoxetine (Prozac) Gabapentin Guanfacine Infliximab Lisdexamfetamine Lithium Lorazepam Melatonin Menthylphenidate Meptazinol Methadone Methotrexate Mirtazapine Modafinil Morphine Naproxen Nefopam Nortripyline Omepresol Omezrapol Oxycodone Paroxetine Pentacozine Pethidine Prednisolone Propranolol Remifentanil Sertraline Sodium Valproate Suvorexant Tapentadol Temazepam Tramadol Trazodone Triazolam Venlafaxine Zolpidem Zopiclone Other Prescribed Medicines / TreatmentsPlease provide further details of your medical conditionOther Prescribed Medicines / Treatments(Required)Please provide further details of your prescribed medicines / treatmentsNameThis field is for validation purposes and should be left unchanged.
