Patient Referral Form

If you think you may benefit from prescription cannabinoids or medical marijuana, please talk to your doctor about a referral to the CMClinic.  Upon being referred, it is critical that all the appropriate documentation is sent to our clinic with your referral prescription to avoid booking delays.

Completed forms and medical history can be faxed to CMClinic at 1-844-320-9652. 

The CMClinic Patient Process 1 – 2 – 3 

 Step 1 – Obtaining a Referral

Talk to your health care practitioner and discuss if medical marijuana might be an option for you. They can then write you a referral (medical document) for an appointment at CMClinic. You must have a referral to be seen at CMClinic along with details pertaining to your diagnosis including recent consultations with specialists and diagnostic imaging reports.  If you are having trouble obtaining a referral, contact us @ 1-888-282-7763.

Step 2 – Fax the Referral to 1-844-320-9652

Check to make sure the following are included in the fax:

  • Get our referral form – Click here.
  • All supporting documentation pertaining to your diagnosis including recent consultations with specialists and diagnostic imaging reports

Step 3 – Appointment Process

Once the referral form is received from your physician with all other required documents, we will contact you to book your appointment.

Download a Patient Referral Form

Contact Us

Phone: 1-888-282-7763
Fax: 1-844-320-9652

Our Patient Care Centre is open Monday through Friday from 7:30am to 7:00pm (EST) 

Toronto 
1 Eglinton Ave. E., Suite 407
Toronto, ON  

Barrie 
11 Lakeside Terrace, 2nd Floor
Barrie, ON  

Ottawa 
1385 Bank St., Suite 305
Ottawa, ON  

Stoney Creek
35 Upper Centennial Pkwy., 2nd Floor
Stoney Creek, ON  

Hamilton
414 Victoria Ave., Suite M6
Hamilton, ON  

Burlington
2951 Walkers Line, 2nd Floor
Burlington, ON  

London
130 Thompson Road
London, ON  

Kingston
725 Arlington Park Place
Kingston, ON  

St Catharines 
180 Vine Street South, Suite 203
St Catherines, ON  

Moncton/Sackville  
112 Main Street, Unit D
Sackville, NB

Halifax  
5991 Spring Garden Rd., Suite 440
Halifax, NS

St. John’s
8-10 Rowan St., Suite 206
St. John’s, NL  

Edmonton
11010-101 St. NW, Suite 608
Edmonton, AB 

Calgary
70 Country Hills Landing NW, Suite 103
Calgary, AB   

Chilliwack
9181 Main Street, Suite 214
Chilliwack, BC