Appointment Request - Phoenix

Note: We changed electronic records keeping systems in Oct of 2016, if you are a returning patient but have not been seen here since then, please select NO to the first statement about being an EXISTING patient and enter your information.

Otherwise, select YES for existing patient.

Also, please note that your RECORD ID is NOT the same as your Arizona Registry Card (MMJ) number. The easiest choice is to select NO for this and enter your name and DOB.

In the Reason for the Appointment Request field, please indicate if this is a RENEWAL for your MMJ card (even if expired) or if you are NEW to the MMJ program.