Green Leaf Medical Of Ohio

Patient Intake Form

Patient Intake Form



Date of Birth

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Are You A Patient or Caregiver

Are You A Veteran or Student?

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Thank you for submitting your intake information. Once your information is uploaded, you'll be able to purchase from gLeaf. A team member will contact you if any of the information is incomplete. Welcome to the gLeaf family!

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Get Your State Issued Card

Need to get your medical marijuana card? Learn how to get a state issued card 

List Of Licensed Doctors

Click Below for a list of doctors who can prescribe the use of medical marijuana


Have questions about Green Leaf of Ohio or using Medical Marijuana?