Schedule a Consultation

Scheduling and registration for qualifying patients age 18 and older

Getting in touch with Dr Sam 420 is easy, with visits being performed via telemedicine/telephone. Please thoroughly read the process below to familiarize yourself with how our office and registration works.

For patients seeking their INITIAL Pennsylvania Medical Marijuana Card, you will need to complete BOTH Step 1 and Step 2 below.

Are you looking to recertify or renew your Pennsylvania Medical Marijuana Card?

Stethoscope With Date Calendar Page Wooden Floor Healthcare Concept

You MUST Complete BOTH

Step 1 and Step 2 below

before we call to schedule your consultation/certification

Step 1

Complete the secure PATIENT INTAKE REGISTRATION FORM (by clicking the box below)

Step 2

Register your PA Driver License/PA State ID with the Dept of Health Medical MJ Program (by clicking the box below)

Once we receive notification that you have completed the Patient Intake Form and are registered with the PA Dept of Health, we will reach out for the scheduling process

Fees

Due to Dr Sam at time of Certification Call

  1. Initial Certification – $149 debit/credit
  2. Recertification (new or returning patients) – $99 debit/credit

After you pay Dr Sam 420 for the consultation, you will then need to pay the state a separate fee for them to print/mail the ID card

Certification

Further Explanation of the Required Steps

STEP 1: FILL OUT A PATIENT MEDICAL HISTORY INTAKE FORM

The black button below takes you to a HIPPA secure form where you must enter your medical information (past medical history, medications that you take, family history, etc). When you click SUBMIT it is transmitted to us securely. Once we have this information we can begin to prepare a file for you. THIS IS THE MOST IMPORTANT STEP HERE. We do create an electronic medical record with this information as required by law. Your intake form will be saved in this chart. This gives Dr Sam the opportunity to become more familiar with your medical history before the consultation with you. It is important to list medications that you are on so Dr Sam can check for any possible interactions.

STEP 2: REGISTRATION WITH DEPARTMENT OF HEALTH

Here is an example of what the registration screen looks like. You MUST enter the address, city and state listed on your current PA State ID. If you have a change of address form (yellow and white card) given to you by PennDot, you MUST use that address. The Department of Health pulls your photo from PennDot to use on your Medical MJ Patient Card. You will be given a 6 digit patient number which you will want to write down and keep in a safe place. You will have to create a username and password to log into this account. If there are issues with registration, you will want to contact the PA Department of Health Medical Marijuana program by calling 888-733-5535. They can assist you with any difficulty in registering your PA driver’s license or PA state ID card.

Pa Doh Patient Reg Orig