Register - Bud Right

Name*

First Last

Date Of Birth*

Email*

Phone*

Address*

Street Address Address Line 2 City Province Postal Code

If applicable, please provide a brief description of the medical condition for which you are requesting cannabis.

(i.e. Medical diagnosis, side effects, physical/mental ailments)

Please provide a brief history of your exposure to cannabis.*

Have you used it in the past? Which form/s of cannabis have you used? Have you ever had any serious side effects?

Government Issued Photo ID*

Please provide a clear scan of a piece of government issued photo id. This id must be issued in Canada and must include your full name and date of birth.

Prescription

If applicable, please provide a clear scan of your medical prescription or doctor’s recommendation. This can be any prescription that medical marijuana will take the place of ex. Pain killers, medication for anxiety or depression etc. We will accept a clear scan of your MMAR license if you currently hold one.

Were you referred to us?*

Yes
No

Details of Referral*

Please enter any relevant details of your referral. For example, if you were referred by a friend, let us know their first and last name so we can reward them!! In turn, when you refer your friend, we'll reward YOU! Or, let us know if you found us on Weedmaps, Instagram, Facebook etc. and you may be eligible for specials!

Terms of Service

By agreeing to the terms of service, the applicant represents that they are at least the age of majority in their province of residence, and that they are ordinarily a resident in Canada.
The applicant affirms that the information provided and the medical document is correct and complete
The applicant agrees that they will use medicinal marijuana solely for their own medical purposes.
The applicant acknowledges that they are using all medical marijuana products at their own risk.
The applicant releases Bud Right and its affiliates from any and all actions, claims, complaints and demands for damages, and loss or injury whatsoever arising directly or indirectly as a consequence of the use of medical marijuana obtained from Bud Right.
The applicant acknowledges that Bud Right reserves the right to refuse service to anyone for any reason at any time, and reserves the right to refuse any order placed or limit and/or cancel quantities purchased at their discretion.
Thank you for choosing Bud right, Canadas premiere online medical marijuana dispensary.

Terms of Service Agreement*

I agrees to these terms

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