ACMPR Application

Start The Process

Our goal is to make accessing a cannabis educated doctor a comfortable and easy experience. You can relax and focus on your health, knowing that all laws are being respected and your information is safe.

Cool Kind will help every step of the way! You can rest assured that your safety and privacy will be treated with the utmost respect while remaining confidentially with our team.

Please complete the form below and submit it for a reply by our Cool Kind team. Please provide as much information as possible.

  1. Name
  2. Phone Number
  3. Email
  4. What Province or Territory do you live in?
  5. Preferred contact day (check all that apply)?
     Mon  Tue  Wed  Thu  Fri  Sat  Sun 
    Preferred contact time (check all that apply)?
     7am - 11am  11am - 3pm  3pm - 7pm 
    Preferred contact method?
     Phone  Email  Phone or Email 
    How did you find us? (required)
     Google Search  Facebook  Instagram  Acquaintance or Friend  Online Ad  YouTube  Twitter  Email  Other 
  6. Subject Title
  7. Message
  8. Do you want to grow your own plants?
  9. How many plants do you want to grow?

* Required