New Patient Intake Form

I have received and read the Central Ave Compassionate Care, Inc. patient education materials.

I understand that I must always carry my Program ID Card while I am in possession of, or transporting, marijuana for medical use, or at an RMD.

I will not engage in the fraudulent use of my registration card.

I understand that my registration only allows me to possess and use marijuana for medical purposes within Massachusetts.

I understand that no one under the age of 18 is allowed in the RMD. Registered patients under the age of 18 have a licensed person caregiver to purchase medicine on their behalf.

I understand that I may not distribute marijuana to any other individual, and must return unused, excess, or contaminated product(s) purchased at Central Ave Compassionate Care,Inc. to Central Ave Compassionate Care Inc. for disposal.

All of the Information Necessary to Become a Patient at Central Ave Compassionate Care.

Please verify your age.