Membership Information

We require the following items to complete membership for H2C Inc:

1.  A current copy of your physician’s recommendation to use medical marijuana.
2.  A valid California Drivers License or California ID.
3.  A completed membership agreement form.

Please note that your recommendation must be verified by your physician.  This may take up to several days.

To expedite the membership process you may fax your recommendation, a copy of your CA DL or CA ID, and your completed membership form to 707-987-9882


You may also use the following online form to initiate the membership process.  Once received, we will verify your information with your physician and contact you by phone.  You will still be required to provide your recommendation, a valid CA DL or CA ID, and a completed membership form upon your first visit to our office.

First Name

Last Name

Phone Number

Date Of Birth

CA DL or ID Number

Physician Name

Physician Phone Number

Physician License Number

Recommendation Expiration Date

Patient Number (optional)

Online Verification Website (optional)

I authorize my recommending physician to
verify to H2C his/her recommendation or
approval for my use of medical cannabis.