In order to order our products and services you must become a member of our collective. We can process your membership once you provide us with a copy of your current physician’s recommendation and your California Driver’s License. If you don’t have a driver’s license, please provide us with a copy of your US Passport and two proofs of California residency.

You can also send these documents to us by fax or email to Staff@Greencellar.org. We’ll contact you upon verification of your recommendation or to request additional information if necessary.

* Fields are required

PERSONAL INFORMATION
First Name *
Last Name *
Email
Phone *
Date of Birth *
CA DL or CA State ID Card # *
Address *
Suite/Apt
City *
Zip Code *
How did you hear about us? *
DOCTOR'S RECOMMENDATION INFORMATION
Dr. Name *
Dr. Phone/Hotline # *
Verification Website/URL *
Patient/Recommendation ID # *
Medical Recommendation Expiration Date *
ATTACH DOCUMENTATION
okYou can take a clear picture of the Doctors recommendation and ID with a camera phone then upload it, if you do not have access to a scanner.
Doctor's Recommendation
CA Driver's License (or US Passport)
Proof of Residency (only if you don't have a valid CA Driver's License)