MCUA - Patient Register Application

Register your interest

MCUA - Medical Cannabis Patient Register
Questions marked by * are required.
MCUA of Australia Inc. - Membership No: *
Email: *
Patient Age: *
City: *
State: *
Postcode: *
Seeking Cannabis Treatment for: *
Cannabis Strains used - if known:
Cannabis products used: *
I agree to MCUA of Australia Inc., or its subsidiaries contacting the doctor I have provided details of to discuss how medical cannabis may suit my situation *
  • YES