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GEM Paperwork Jotform Menu

A. TM 
https://www.greenearthmedicine.com/tm-telemed-appt-questionnaire
 
B1. [OAP+OAF]
https://www.greenearthmedicine.com/b1-oap-oaf
 
B3. OAP Only
https://www.greenearthmedicine.com/b3-oap-only-no-fees
 
C. OAP only
https://www.greenearthmedicine.com/c-oaf-oap-fee-form
 
D. PWSF/EXPWSF
https://www.greenearthmedicine.com/d-paperwork-service-fee-options
 
E. Medical Eval/Documentation
https://www.greenearthmedicine.com/e-medical-evaluation-appointment-questionnaire
 
F1. ROI
https://www.greenearthmedicine.com/f1-release-of-information
 
G. OMMP Verbal Consent
https://www.greenearthmedicine.com/g-ommp-verbal-consent-form
 
I2. Medical Screening for Cannabis Psychotherapy
https://www.greenearthmedicine.com/i2-med-screening-cannabis-psychotherapy
 
J. Cannabis & Botanical Consultation
https://www.greenearthmedicine.com/j-cannabis-health-consultation-questionnaire
 
K. Ketamine Outpatient Screening Intake
https://www.greenearthmedicine.com/j-cannabis-health-consultation-questionnaire
 
K2. Ketamine Full-Dose Screening Intake
https://www.greenearthmedicine.com/ketamine-full-dose-screening-questionnaire
 
L. Records Uploader
https://www.greenearthmedicine.com/uploader
 
O1. New Client Psylocybin Intake Coile
https://www.greenearthmedicine.com/new-client-psilocybin-intake-coile
 
O2. New Client Psychedelic Screening Coile
https://www.greenearthmedicine.com/pyschedelic-therapy-screening-coile
 
O3. Psychedelic Post-Treatment Questionnaire
https://www.greenearthmedicine.com/psychedelic-post-treatment-questionnaire
 
P. Outpatient Screening for Psychedelic Microdose & Other Therapies
https://www.greenearthmedicine.com/outpatient-screening-psychedelic-microdose-therapies
 
PWS Terms of Service 
https://www.greenearthmedicine.com/pws-terms-of-service
 
OR Proof of Residency |
https://www.greenearthmedicine.com/or-proof-of-residency
psychedelics

service areas: Adair Village, Adams, Adel, Adrian, Ainsworth, Albany, Allegany, Alsea, Amity, Antelope, Arlington, Ashland, Astoria, Athena, Aumsville, Aurora, Baker City, Bandon, Banks, Barlow, Bay City, Boardman, Bonanza, Boring, Brookings, Brothers, Burns, Butte Falls, Camas Valley, Cannon Beach, Canyon City, Canyonville, Carlton, Cascade Locks, Cave Junction, Central Point, Chiloquin, Clatskanie, Coburg, Columbia City, Condon, Coos Bay, Coquille, Cornelius, Corvallis, Cottage Grove, Creswell, Culver, Dallas, Dayton, Dayton, Depoe Bay, Detroit, Donald, Drain, Dufur, Dundee, Dunes City, Durham, Eagle Point, Echo, Elgin, Elkton, Enterprise, Estacada, Eugene, Fairview, Falls City, Florence, Forest Grove, Fossil, Garibaldi, Gaston, Gates, Gervais, Gladstone, Glendale, Gold Beach, Gold Hill, Grand Ronde, Grants Pass, Grass Valley, Gresham, Halfway, Halsey, Happy Valley, Harrisburg, Heppner, Hermiston, Hillsboro, Hood River, Hubbard, Huntington, Imbler, Independence, Ione, Jacksonville, Jefferson, John Day, Johnson City, Jordan Valley, Joseph, Junction City, Keizer, King City, Klamath Falls, La Grande, La Pine, Lafayette, Lake Oswego, Lakeside, Lakeview, Lebanon, Lincoln City, Lonerock, Long Creek, Lostine, Lowell, Lyons, Madras, Malin, Maupin, McMinnville, Medford, Mill City, Milton-Freewater, Milwaukie, Mitchell, Molalla, Monmouth, Monroe, Monument, Moro, Mosier, Mount Angel, Myrtle Creek, Myrtle Point, Nehalem, Newberg, Newport, North Bend, North Plains, Nyssa, Oakland, Oakridge, Ontario, Oregon City, Pacific City, Pendleton, Philomath, Phoenix, Pilot Rock, Port Orford, Portland, Powers, Prairie City, Prineville, Rainier, Redmond, Reedsport, Riddle, Rockaway Beach, Rogue River, Roseburg, Rufus, Salem, Sandy, Scappoose, Scio, Scotts Mills, Seaside, Sheridan, Sherwood, Silverton, Sisters, Spray, Springfield, St. Helens, St. Paul, Stanfield, Stayton, Sublimity, Sutherlin, Sweet Home, Talent, Tangent, The Dalles, Tigard, Tillamook, Toledo, Tualatin, Turner, Umatilla, Union, Unity, Vale, Veneta, Vernonia, Waldport, Wallowa, Warrenton, Wasco, Waterloo, West Linn, Wheeler, White City, Willamina, Williams, Wilsonville, Winchester Bay, Winston, Wood Village, Woodburn, Yachats, Yamhill

Business Mailing Address:
GEM Clinic

PO Box 1485

Grants Pass, OR 97528
Phone: (503) 272-8781​
Fax: (503) 536-6458

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©2019 by Green Earth Medicine

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