(520) 412-9026 ContactUs@MMjCCC.com

Intake and Consent Form

If you have medical records, or you are sure you will have them by your preferred appointment time, complete this form to confirm that you have a qualifying condition and that you consent to being seen as a patient.

To complete the Intake Form, click HERE.

During the COVID-19 Crisis we are offering telemedicine visits only, by appointment only.