Radicle Health does not sell or distribute medicine.

New Patient Health History

arrow&v
arrow&v

Please check any of the following symptoms that you have been experiencing:

Anxiety

Depression

Fatigue

Impaired strength or ability

Insomnia

Intractable Pain

Loss of appetite

Muscle atrophy

Nausea

Weakness

Weight loss

Other (please specify):

Please check any of the following medical conditions that you have been diagnosed with:

Other (please specify):

Multiple Sclerosis

AIDS

ALS

PTSD

Cancer

Crohn's Disease

Glaucoma

Hepatitis C

HIV positive

Parkinson's Disease

Please check any of the following medical conditions that you have been diagnosed with:

Please check any of the following aspects of your life that have been negatively impacted by your condition(s)
and/or symptom(s):

Emotional

Mental

Physical

Recreation

Social

Work

Other (please specify):

Focusing just on your most pressing health concern, please answer the following questions:

What are the current symptoms associated with this health concern?

What makes this condition better? What makes it worse?

Does this condition improve with marijuana use? Please explain.

Describe or explain the onset of this condition. How did it start?

What type of workup have you had for this condition (doctors seen, tests performed, etc.)?

What treatments have you tried? How well have they worked?

What treatments have you tried? How well have they worked?

arrow&v

If you are currently in pain, where is your pain?

Please tell us about your current medical provider (name of doctor or practice, or location)