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Register for Medical Cannabis

Registration is: CLOSED

Online registration with Northern Green Canada is currently unavailable, as our registration process is being upgraded to serve you better.

To register with us at this time, please contact our Client Services team directly at clientservices@northerngreencanada.com, or by phone at 1-866-233-3707. We apologize for any inconvenience and appreciate your patience.

Instructions

Step 1
Download the Registration Form

Register With Us

Submit your registration information to us through the form on this page. If you require a paper version, download it below (submission instructions for paper forms within).

Registration Form
Step 2
Find a Clinic Near You

Complete an Assessment

Book an appointment with your chosen Health Care Practitioner. Remember to bring our Medical Document to your appointment and request NGC as your provider. Upon approval for medical cannabis, your HCP will submit your documentation to us for verification.

Medical Document
Step 3
Start Shopping!

Start Shopping

Once we receive all of your documents, getting approved takes 1-2 days. We'll activate your account and notify you, so that you can login to our Client Portal and start shopping.

If you have any questions or comments, please contact our Client Services team or visit our Support page for more information.

Visit our Support page

Patient Information

Residence Address

Please indicate if the address above is:



Only complete this section if you selected A Non-Private Resident

Residence Manager Info

Shipping Information

Where will we be shipping your medicinal cannabis?


(This can only be selected if this Different Mailing Address is your primary address for Canada Post)

Note: You will need your prescribing Healthcare Professional's written permission in order to ship your medical cannabis to their office. This certification can be granted on your Medical Document

Individual Responsible for Applicant



Caregiver Info

Direct Billing for Canadian Forces Veterans

In order for us to bill Veterans Affairs Canada directly for the cost of your medicine, we require the following information:

  1. Your healthcare professional must provide a diagnosis on your Medican Document
  2. Your Veterans Affairs Canada Health Benefit Card number
  3. A completed Veterans Affairs Canada Consent to Disclose form (available HERE and on our website

* By including your VAC Health Care ID Card Number, you indicate that you plan to submit the NGC Veterans Affairs Canada Consent to Disclose Form, and we will contact you to assist you with this submission process.

Compassionate Pricing Promise

Northern Green Canada offers a Compassionate Pricing Program to our clients who qualify for financial assistance to obtain medical cannabis. Eligibility and Supporting Documentation requirements can be found within our Compassionate Pricing Form. Please indicate below if you will be submitting this document so we can assist you with this process.

Additional Information

By signing this Registration Form, you give us permission to send medical cannabis and your registration information to the shipping address provided. You also give us permission to communicate with you at your listed email address so that we can provide you with information related to your account and purchases.

Please indicate if we may also email you regarding product availability, and other Northern Green Canada updates



Do you have prior experience with cannabis? If so, do you have any cannabis preferences, so that we may better assist you in your product search? (e.g. Indica vs. Sativa, Oils vs. Dried Flower, etc.)

Are you interested in participating in clinical trials for or through Northern Green Canada?

Authorization

Patient Information

Northern Green Canada (NGC) is required to collect the following personal information from applicants to comply with Health Canada regulations to Access to Cannabis for Medical Purposes Regulation (ACMPR). This information may be amended from time to time. The information collected by NGC stays confidential. NGC uses and discloses personal information in accordance with the provisions of the Personal Information Protection and Electronic Documents Act (PIPEDA), the Ontario Personal Information Protection Act, ACMPR, and NGC’s privacy policy. Personal information collected in these forms is only for the purposes of providing medical cannabis and related services to applicants.

Signee Acknowledgements

The signee hereby confirms the information set out in the application is correct and complete and that Northern Green Canada is relying on this information.

The signee hereby states:

  1. The applicant ordinarily resides in Canada;
  2. The information in the application and the medical document is correct and complete;
  3. The medical document is not being used to seek or obtain fresh or dried marihuana or cannabis oil from another source;
  4. The original of the medical document is provided in support of the application;
  5. The applicant will use fresh or dried marihuana or cannabis oil only for their own medical purposes.
  6. The applicant consents to the health care practitioner named in the Medical document disclosing required personal health information to the Northern Green Canada for the purpose of registering the applicant in compliance with the requirements of the Access to Cannabis for Medical Purposes Regulations.
  7. The applicant is aware that the benefits and risks associated with the use of marihuana are not fully understood and that the use of marihuana may involve risks that have not been identified; and the applicant accepts those risks
  8. By signing this registration form, applicant or caregiver (if applicable) allow Northern Green Canada to send registration information to the mailing and email addresses provided therein.

The signee hereby acknowledges that this Application requires you to provide certain Personal Information to Northern Green Canada. Such information is being collected and will be used by Northern Green Canada for the purposes of completing your registration, which includes, without limitation, determining your eligibility to purchase products from Northern Green Canada, for determining your qualification for financial assistance, if available to you, from certain third parties (i.e.Veteran’s Affairs Canada)

Quebec’s Commission de la santé et de la sécurité du travail or private insurance companies) (collectively, “Authorized Third Parties”), for research and study purposes and for providing ongoing support to you. You hereby agree that your Personal Information may be disclosed by Northern Green Canada to: (a) Authorized Third Parties, (b) any parties, including but not limited medical or academic researchers, involved in conducting research or study services but only provided such parties are under strict obligations to maintain the confidentiality of the Applicant’s Personal Information and (c) Northern Green Canada client support team. By signing this Application, you consent to the foregoing collection, use and disclosure of your Personal Information.