Become a Member To become a member, fill out the form below and we will get back to you shortly. Once your membership has been activated, you can begin placing orders online. Note: California residents only. Name* First Last Email Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific California residents only. ZIP Code Type of Membership*PatientRecreationalName of Doctor*Doctor License Number*Patient Medical Number*Doctor's Recommendation Expiration Date* Name of Clinic*I am 21 years of age or older*YesNoI declare under perjury that I am NOT a law enforcement officer, associated or affiliated with City, State or Federal government agency*YesNoTerms & Conditions* Check here if you have read and agree to terms and condition below. I rely on By The Oz services as the source of medical cannabis for matters of my personal health and safety until my physician recommendation expires. I declare under the laws in the State of California that the above information provided by me are true and correct. I hereby declare that I am a patient suffering from an illness and have obtained a recommendation from my physician I assign Management of By The Oz to assign a commercial grower who has permission to grow medical marijuana in a certain County to cultivate and process on my behalf. This Agreement shall be accompanied by the following: a) Copy of Physician's recommendation of the member; b) Valid CA ID, and c) Registration of the Patient to a Collective where Medical Marijuana shall be dispensed. To the best of my ability, this Agreement/Authorization to Cultivate was prepared and protocol set in placed to comply with the California Attorney General guidelines adopted in August 2008 for the security and non-diversion of marijuana grown for medical use ONLY. Doctor's RecommendationAccepted file types: jpg, gif, png, pdf.Driver's License*Accepted file types: jpg, gif, png, pdf.NameThis field is for validation purposes and should be left unchanged.