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Rise Dispensaries!

Before we let you in ...

Are you over 21 years old*?

*For Pennsylvania, New York, Maryland and Minnesota you must be 18+

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Please come back and visit when you are old enough!

New York Patient Registration Form

Thank you for your interest in registering with our dispensary. Please complete the Patient Pre-Registration form below. If you have any questions, please contact us and a patient care specialist will reach out to you.

New patients: You must bring your patient certification form each time you visit the dispensary.

1 Part 1*

Personal Info

2 Part 2

Medical Cannabis History

3 Part 3*

Privacy Practices Notice

4 Part 4*

Code Of Conduct Agreement

5 Part 5*


Thank You For Being Here!

We are honored you’ve chosen RISE as your medical cannabis provider. We look forward to getting to know you. Please tell us a little about you and your history with medical cannabis.
Yes, I would like to receive information, community updates, and special offers. We promise we will not sell or share your contact information.
Home Address
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Are you facing any financial hardships?
Are you a Senior
Are you a Veteran?
Current Medications? (Prescription & Nutritional Supplements)

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