Health Canada's optional 3-page sample is the medical document a practitioner provides so a patient can buy cannabis for medical purposes from a federally licensed seller, or register with Health Canada to produce it. It records the daily quantity of dried cannabis in grams and an authorized period of use of up to one year. Any document containing the information section 273 of the Cannabis Regulations requires is acceptable.
A health care practitioner as defined in the Cannabis Regulations, meaning medical practitioners and, in some provinces, nurse practitioners, completes and signs the whole document for a patient under their professional treatment. The patient registers with the licensed seller, or applies to Health Canada, separately.
Download the current version from the source each time; forms change without notice.
Medical document authorizing the use of cannabis for medical purposes
Document médical autorisant la consommation de cannabis à des fins médicales
If your copy of the form is a fillable PDF, upload it once and Vero Documents fills it from the visit note and the chart, ready for you to review and sign. Download, print, or email the finished form, with the patient’s consent.
A form is listed only after its name and number were confirmed on the issuing agency’s or insurer’s own website, or in the form itself. Each entry links to that source. The list was last checked in October 2026. Forms change without notice, so download the current version from the official page before you fill it in.
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No. The sample is optional. A practitioner may use a different form or letter, as long as it contains all the information section 273 of the Cannabis Regulations requires, such as practitioner and patient details, the daily quantity of dried cannabis in grams, and the period of use.
Health Canada says a health care practitioner under the Cannabis Regulations includes medical practitioners and, in some provinces, nurse practitioners. The practitioner must have the patient under their professional treatment, support that cannabis is required for the condition being treated, and not be restricted by provincial or territorial law from authorizing it.
Yes, by secure fax in two situations: when the patient asks you to send it directly to a federally licensed seller, or when Health Canada asks you for a new document for a production or possession application. Initial the matching statement on page 3, and the faxed copy counts as the original.