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Please note: Even after new regulations take effect on January 1, 2018, E&M Medicals is an educational non-profit focusing on cannabis as an alternative which consults with, and provides products to, clients with medical conditions.

In addition to completing the written portion of the online form, a copy of your doctor’s recommendation ( if you have one) and a valid photo ID is required. If you do not have a medical recommendation, please upload your ID in both areas so that the application can be processed. 

If you have issues with the application form you can scan and email the documents, or take a picture of it with a smart phone if you don’t have a scanner.


*This form works for computers and tablets, but not all mobile devices.

I understand and agree as follows;

I am a qualified patient protected by California Health and Safety Code 11362.7, Proposition 215 and Senate Bill 420. My Doctor has recommended the use of medical cannabis and provided written documentation of such recommendation. My doctor will review my case on a yearly basis. Per the relevant sections of California law, I am able to possess, use, and cultivate cannabis for medical purposes. I agree not to sell E&M Medicals products to third parties. I agree to follow all the rules and guidelines of E&M Medicals.

Disclaimer – General Release, Indemnification and Hold Harmless Clause:

I, Being of lawful age and sound mind, do now release, acquit and forever discharge E&M Medicals from all actions, claims, demands, or damages accruing to me from any known or unknown injury, loss or damage sustained by or to me. This release shall remain if force and run concurrently with my membership. I further agree to indemnify and hold harmless E&M Medicals from any injuries or damages resulting from use or misuse of the medical cannabis products obtained from the collective.

I, as a member of E&M Medicals, have been advised at the onset of accepting membership, that any representations or recommendation made by the staff at E&M Medicals is not an examination, diagnosis, or a prescription by a person licensed to practice medicine in this state and therefore must not be regarded as medical opinion. In addition, I acknowledge that I am not employed by any law enforcement or regulatory agencies.

I hereby sign and agree to join E&M Medicals.

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