To check your eligability to be considered for plant based therapies, answer the questions below. This is a simple pre-screening and will take about 30 seconds. Once you have booked your new customer consultation we will get to know you with a more detailed questionaire.

First name *

Surname *

Email address *

Mobile Number *

Do you have a chronic medical condition(s) and diagnosis you want to address in your consultation.

YesNo

Hydralyfe clients must have a chronic condition in order to qualify for cannabis therapies. Chronic conditions are those with long lasting and persistent affects greater than three months. Some examples include pain, anxiety, insomnia

Please contact our staff to discuss further call 1300 149 378

Have you used prescription medication, over the counter supplements or medicine, herbal medicine or natural therapies, allied or other health professionals or any other mechanisms to help you manage symptoms ?

YesNo

Please contact our staff to discuss further on 1300 149 378

Have conventional medicines/treatments failed to fully resolve your medical condition or have you avoided treatments due to negative side effects?

YesNo

In order to be eligible conventional medicines/treatments must have failed to fully resolve your condition or negative side effects experienced. Please be prepared to discuss this during your consultation if not described here.

Please contact our staff to discuss further on 1300 149 378.

Have you ever experienced psychosis?

YesNo

Note* Psychosis - a severe mental disorder in which thought, and emotions are so impaired that contact is lost with external reality

Please contact our staff to discuss further 1300 149 378

Are you pregnant, breastfeeding or planning a pregnancy?

YesNo

Unfortunately, we are unable to provide a prescription for medical cannabis. Please call us on 1300 149 378

Please continue to our booking form