Phoenix Marijuana Delivery

MA Card

Do You Qualify

Just fill out the form on this page to Pre-Qualify for your Massachusetts Medical Marijuana Card


Fill out the form below to begin pre-qualifying for your medical marijuana card.

A representative from Massachusetts Marijuana Doctors will contact you shortly to obtain your medical records, pre-qualify your condition, and setup an appointment for you to see the doctor.

Click here to view the entire process that is required to get a medical marijuana card.

*(denotes required field)




First Name: *

Last Name:*

E-Mail Address:*

Your Phone Number:*

Are you a resident of Massachusetts?*

 Yes

 No

Do you have a valid Massachusetts Driver’s License of ID? *

 Yes

 No

Are you at least 18 years of age?*

 Yes

 No

Do you currently have medical records diagnosing your condition?*

 Yes. I have them in my possession.

 Yes. But my doctor has them.

 Yes. But I am not sure where they are located.

 No. I do not have any medical records.

Which of the following qualifying conditions do you have?*

 Crohn's Disease

 Glaucoma

 Parkinson`s

 HIV

 AIDS

 Hepatitis C

 Agitation of Alzheimer's Disease

 Amyotrophic Lateral Sclerosis (ALS)

 Multiple Sclerosis

 Other Conditions determined in writing by a qualified physician:

 Chronic Pain of at least 6 months duration

 Chronic muscle spasm

 Cachexia (wasting syndrome)

 Agitation of Alzheimer’s disease

 PTSD

 Painful peripheral neuropathy

 Terminal illness (hospice care)

 Radiculopathy

 Degenerative Arthritis

Approximately when did your condition begin?*


Are you currently receiving treatment for this condition?*

 Yes

 No

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Medical Marijuana Doctors

Do You Qualify?

1. The first step to obtain your Massachusetts Medical Marijuana Card is to Click this link and fill out the form.

2. Once we receive it will contact you at the phone number you provide.

3. We will explain the process and answer all your questions.

4. Your current medical records will be required. If you don’t have them, we will request them from your doctor for you.

5. Our doctors will review your records and will then contact you to set up your evaluation appointment.

Call us today at 617-997-0300 or email info@BMMCC.com

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