6-Month Permit Online Renewal
Available for patients with a valid control card who already have a 6-month permit which was approved <1year ago
Sign in to Google to save your progress. Learn more
Email *
Name and surname *
ID card number *
Mobile number *
Expiry date of 6-month permit *
MM
/
DD
/
YYYY
Expiry date of control card *
MM
/
DD
/
YYYY
Which products were approved on your current 6-month permits *
Required
How many grams (approximately) do you consume daily? *
Required
How do you consume your medicine? *
Required
Do you use CBD? *
Required
What symptoms did the medicine help you relieve? *
Required
Describe briefly how the medicine helped you *
What negative side effects did you experience? *
Required
Which products would you like to continue using for the next 6 months? *
Required
I hereby declare that I have answered honestly and to the best of my ability. I take full responsibility for my answers and understand that the decision to re-approve my treatment is at the sole discretion of the prescribing doctor. *
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy