Patient Registration

Step 1 of 2

Legal First Name

Legal Last Name

Telephone Number

Email Address for State Registration

Password for State Login - COMPLIA - MMMP - State Login Password (The password to view your medical card)

SSN - if in Ohio, please enter Driver's License (DL) or State Identification (State ID) number

Address

Street Address Address Line 2 City State ZIP Code

Please provide details on what we are treating you for.(Required)

Easy Certification and Renewal Services!

Our Staff is trained to provide everything you need!