top of page
plants.jpg

Please complete the Form

Question Regarding:*

If you would like Dr. Forbush to review your medical records to confirm qualification for the OMMP program for a small fee please have your Physician fax your information to our office.  The fee will be deducted from the cost of Initial OMMCP Consultation. Be Well!

*Qualifying Medical Conditions

AIDS/HIV

ALS/amyotrophic lateral sclerosis

Alzheimer’s/dementia

cancer

cachexia

traumatic brain injury & chronic traumatic encephalopathy

Crohn’s disease, Ulcerative Colitis, Inflammatory Bowel Disease/IBD (NOT Irritable bowel syndrome/IBS)

epilepsy/seizure disorder

fibromyalgia

glaucoma

hepatitis C

MS/multiple sclerosis

pain that is either chronic & severe or intractable

Parkinson’s disease

post-traumatic stress disorder (PTSD)

sickle cell anemia

spinal cord disease or injury

Tourette’s syndrome

*MD/DO must have documented diagnosed condition in medical record per state law.

 

OMMCP Helpline - Ohio Medical Marijuana Control Program

1-833-4OH-MMCP (1-833-464-6627)

The Ohio Medical Marijuana Control Program Toll-Free Helpline responds to inquiries from patients, caregivers, and health professionals regarding adverse reactions to medical marijuana, and provides information about available services and additional assistance as needed.

 

Please remember: qualifying condition MUST be recorded by an MD or DO ONLY per state law. Unfortunately, records from chiropractors or solely NP/PAs are not in compliance with the program. They can be used to add evidence to a condition but cannot stand as sole proof of a qualifying condition.

Contact Information

Phone

Email

Address

Office: 614-483-3920

131 Oak Meadow Dr, Ste 100

Pataskala, OH 43062

Fax: 614-349-4964

bottom of page