THC Patient Medical History Form THC New Patient Intake Texas Herbal Clinic Telemed Consent

Please fill out the following and we will contact you within 24 hours. Or, you may call us directly M-F from 9 AM to 5 PM central

Phone # 713.955.3325

SW Office
4141 Southwest Fwy Suite 315
Houston, TX 77027

NW Office
5700 NW Central Drive Suite 170
Houston, TX 77092

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      Are you seeing a pain management provider?

      If so, name and contact info

      Have you been diagnosed with any qualifying conditions to be enrolled in the Texas Compassionate use program?

      If yes, please upload medical documents here

      Please upload a picture of your Texas DL here