In order for patients to be referred to our doctors for a medical cannabis consultation they must get a referral from their regular doctor. This includes a Patient Health Summary as outlined below:

1) A request for Medicinal Cannabis treatment

2) An “Indication” i.e. the chronic condition or symptom for treatment, e.g. chronic pain

3) Clinical justification for the Medicinal Cannabis treatment, e.g. other treatments have failed

4) Current medications and treatments

5) Previous unsuccessful medications and treatments


Referrals should be emailed to or faxed to 02 916 77 191.

The buttons below provide referral templates for your doctor to complete. The Handwritten version is to print. Please only use the PDF version if you have a digital signature.

If you have any trouble with your regular doctor providing a referral to us, please tell them to get in touch with us. We’re happy to help.

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