Eligibility Test - CDA Clinics

Do you have a medical condition that has lasted more than 3 months?*
- YES
- NO
Have standard medicines failed to fully treat your medical condition or have you avoided treatments due to negative side effects?*
- YES
- NO
Have you avoided standard medicines due to side effects or potential side effects?*
- YES
- NO
It looks like you qualify for Medicinal Cannabis*. Would you like an information pack?*
* subject to confirmation by our doctors in consultation.
- YES
- NO

You're eligible!

Now all you need for a Medial Cannabis Consultation is a referral and health summary from your regular Doctor. Please enquire below for an info pack
You're likely still eligible

Please enquire here and ask for a an eligibility screening over the phone.
I'm**
Patient's First Name**
Patient's Surname**
Carer Full Name**
Carer Email**
Patient's Email**
Phone**
Patient Date of Birth**

DD
MM
YYYY
State/territory**
What is your primary condition diagnosis?**
Other Primary Condition**
How long has the condition lasted?**
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How long has the condition lasted - old
Symptoms**
Other Conditions (Not Required)
Which cannabinoids are you interested in discussing with our doctors?**
Do you have any previous experience or knowledge of Medicinal Cannabis?**
Extra Notes (Not Required)
How did you first hear about us?**
Other**
Consent**
- I agree to the CDA Health and CDA Clinics Privacy Policy and Trading Terms & Conditions.
When you click submit, a submission confirmation will appear on a new page. Please wait for this before clicking submit again.

Thank you for taking part in our eligibility screening.
Check out our FAQs and News pages if you'd like to know more
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- CDA Clinics
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Are you eligible for a CDA Clinics Consultation?