How to Get Started

Our Fee Structure

Our fees cover the detailed work done by the physician and staff, both before and after the consultation, to ensure the patient is in compliance with all Florida law requirements.

  • Evaluation Certification/Recertification Only: $150
  • Evaluation Certification/Recertification and Medical Cannabis Dosing/Treatment Management: $250
  • Medical Cannabis Dosing/Treatment Management Only (no certification/recertification):
    • $150 – 250 (based on complexity and length of appointment)
  • Second Physician Chart Review for Pediatric Patients: $75 (required by the State of Florida for patients under age 18)
  • Second Physician Chart Review for Pediatric Patients and Medical Cannabis Dosing/Treatment Management:
    • $150 – 250 (based on complexity and length of appointment)

How to Register

  • All patient registration material must be submitted electronically through our Electronic Medical Record system.
  • If you would like to set up a patient portal to receive registration information, please complete the Initial Intake Form below.
  • Please review our HIPPA Policy Notice

Wholistic ReLeaf Contact Information

  • Email: info@WholisticReLeaf.com
  • Phone
    • Non-Urgent Calls: (813) 603-4425, will be returned within 2 business days
    • Emergency Calls: Dial 911 or contact the patient’s primary care physician or specialist
  • Fax: (813) 603-4427

Initial Intake Form

If you believe you or a loved one may qualify to be treated with medical cannabis in the State of Florida, please provide us the information requested below and someone on our staff will get in touch with you.





Your Name:

Date of Birth:

Email:

Contact Phone:

Qualifying Condition: The patient has been diagnosed with the following debilitating medical condition by a qualified, licensed health care provider or mental health professional. This diagnosis is stated in the official clinical documentation that will be submitted to Family Medical Cannabis Clinic.

Other Condition (if not listed above):

Zip Code:

How You Heard About Us:

Other Source (if not listed above):

 

Want to know more? Download our informational guide on medical cannabis.

Medical Cannabis Information Guide

Footer Social Connects

Copyright

3405 W. Fletcher Ave Tampa, FL 33618 | (813) 960-3415

© 2017 Wholistic Pediatrics and Family Care. All rights reserved.