duber3c@gmail.com
586-222-2633
Mon-Thurs: 11am - 10pm, Fri-Sat 11am - 11pm, Sun: 12pm - 10pm

Sign Up/New Patient Verification Form

Pre-registration requests are usually processed within 24hrs. Some doctor's offices can take up to one week to verify recommendations letters. Please use this form if you are requesting delivery or if you are planning a visit in the next few days. We will contact you and let you know as soon as your pre-registration is complete.

Please make sure to bring your ID and recommendation upon your first visit, or have it ready for your first delivery.



To order for delivery, please enter your address:

Mr Nice Guy's has my permission to place calls to me at the number I provide in this Patient Verification Form, with information about Mr Nice Guy's products or services in which I may be interested. I understand that as a result of giving this permission, I may be contacted by someone calling on behalf of Mr Nice Guy.
Would you like to receive communications from Mr Nice Guy's about specials, promotions, newsletters, action alerts, and more?

Doctor / Clinic Information

(For verification purposes, the ZIP code on file with your doctor/clinic for your recommendation)


Please make sure to also bring your Doctor's recommendation and ID with you to your first visit.



Address:
Servicing Macomb and Oakland Counties
Phone:
586-222-2633
Email:
duber3c@gmail.com

Are you a Michigan Marijuana Card Holder and 18 years old or older?

Please verify you're a card holder and at least 18 years old