Starseed Medicinal Inc.

Step 1
Register with Starseed

We make registering for medical cannabis quick and seamless. Begin the registration now
Step 2
Get Medical Document

Before you can order medical cannabis, it is required that you complete a medical document with a licensed health care practitioner
Step 3
Get Approved & Start Shopping

Once we receive your medical document and approve it, you are able to make your first medical cannabis order

Start Shopping

First let’s create your account

Patient Signature – Sign via touch

Reset

I acknowledge, attest, agree and consent to the following information covered in Starseed's Applicant Consent (Required)

I have read and understood Starseed's Privacy Policy (Required)

I consent to participate in Starseed's Chronic Pain Research Studies (Optional)

Let us know a bit more about yourself

First Name First Name

Last Name Last Name

Birth Date Birth Date

Gender

Telephone Telephone

Allow us to leave voicemail, in case we need to contact you

How did you hear about us?

Referred By (Optional) Referred By (Optional)

I am completing this application

Caregiver #1 Information

First Name First Name

Last Name Last Name

Date of Birth Date of Birth

Telephone Telephone

I am responsible for the applicant

Caregiver #1 Signature – Sign via touch

Patient Signature – Sign via touch

Reset

Date Date

Would you like to add another Caregiver?

Caregiver #2 Information

First Name First Name

Last Name Last Name

Date of Birth Date of Birth

Telephone Telephone

I am responsible for the applicant

Caregiver #2 Signature – Sign via touch

Patient Signature – Sign via touch

Reset

Date Date

Add Your Address

Add your primary residence address, as well as any other addresses if necessary.

Residence Address
(required)

Choose as my shipping address
Alternate Mailing Address
(optional)

Choose as my shipping address
Practitioner Address
(optional)

Add your practitioner's address only if you want us to ship to your practitioner instead

Choose as my shipping address

Find Your Address

Please enter your address in order to complete the registration document

Finish your Address

Please check to see if your address is correct and add a unit number if necessary.

Patient Signature – Sign via touch

Reset

Address Contact

Address

Practitioner Information

Practitioner Signature – Sign via touch

Reset

Are you a part of an Employer Program / Union?

Which Employer Program / Union and Local are you part of?

Employer Program / Union

Status / Local

Member Type

Please confirm the following:

My Local

Insurance Company

Group Insurance Number

Please Confirm Your Benefits Plan Information

What is your member number?

Full Name of Primary Plan Member

Membership Number

Preference of Contact

Last two numbers of drug card Last two numbers of drug card

Licensed Producer/Seller Name Licensed Producer/Seller Name

Licensed Producer/Seller Phone Number Licensed Producer/Seller Phone Number

Email Email

Telephone Number Telephone Number

Fax Number Fax Number

Are you under other benefits plan?

Yes No

Start Date Start Date

Company Company

Policy Number Policy Number

Member Number Member Number

Does the patient have drug coverage under any other group benefits plan?

Yes No

Start Date Start Date

Company Company

Policy Number Policy Number

Member Number Member Number

Name of Plan Member Name of Plan Member

Relationship to Patient Relationship to Patient

Provide details and attach documentation of acceptance or decline Provide details and attach documentation of acceptance or decline

Is the patient currently on, or previously been on this drug?

Yes No

Start Date Start Date

Coverage Company Coverage Company

*if coverage is not provided by Canada Life please provide pharmacy print-out showing purchase of this drug.

Does the patient have coverage under a provincial program or from any other source?

Yes No

Name of program or other source Name of program or other source

Provide details and attach documentation of acceptance or decline Provide details and attach documentation of acceptance or decline

Is the patient currently receiving disability benefits for the condition for which this drug has been prescribed?

Yes No

Has the patient enrolled in the patient assistance program for this drug?

Yes No

Patient assistance program patient ID number Patient assistance program patient ID number

Contact Person Name Contact Person Name

Phone Number Phone Number

Do you have your own insurance?

Do you have Medical Cannabis Coverage?

My Insurance Details

Insurance Company

Group Policy # Group Policy #

Cert/Member # Cert/Member #

Are you a Veteran?

What is your Veteran K Number?

Veteran K Number Veteran K Number

Thank you for registering with us!

Click below to complete your registration.

Complimentary At Home Consultation

A service provided by our partner Wayfare Nursing for medical cannabis assessments and personalized programs. Please check your inbox as you will need to complete the intake form sent by Wayfare to confirm your appointment.

Instruction for your Health Care Practitioner

Great! You already have a medical document ready. We will need to receive and verify it before you can make your first medical cannabis order.

Print or show these instructions to your health care practitioner

Email sent Something is wrong. Please try again later

Step 1

Download the following PA form (if applicable) and complete them with your Health Care Practitioner.

Download Benefit Form

Step 2 - Send us your completed form and medical document

Please note your health care practitioner must complete page 3 of your PA form (if applicable)

Secure Fax Sfax (1-844-756-0470)
Print and mail to:
Entourage Brands Corp.
P.O Box 69
Bowmanville, Ontario
L1C 3K8

Connect to Healthcare Professional

Connect with a health care professional online now (it will take under 30 minutes) or book an appointment for later.

Online Appointment

Select One of the following options:

Instruction for your Health Care Practitioner

Great! You already have a medical document ready. We will need to receive and verify it before you can make your first medical cannabis order.

Print or show these instructions to your health care practitioner

Email sent Something is wrong. Please try again later

1. Download forms & Complete with health care practitioner.

You must download your medical document and PA forms (if applicable) and complete them with your health care practitioner.

Medical Document

Download Benefit Form

2. Send us your completed forms

Get your health care practitioner to send us your completed forms SFAX

Get your Health Card Practitioner to SFAX the completed medical document to us

Secure Fax Sfax (1-844-756-0470)
Print and mail to:
Entourage Brands Corp.
P.O Box 69
Bowmanville, Ontario
L1C 3K8

You Must Connect to a Medical Doctor

We are unable to schedule a practitioner appointment for you at this time as we've been informed that your benefits policy may have changed. For further information, please contact your benefit provider:

LiUNA Local 837: https://liunalocal837.com/benefits/

LiUNA Local 1059: https://liunalocal1059.com/

You will be entering a wait room, please hold while a patient coordinator connects with you

Select appointment type

Select Location

Please select the location you are able to attend in person. If none of these options work, please consider an online consultation.

Closest Available Time Slots

Appointment Calendar

Enter health card

Health Card Province

Health Card Number Health Card Number

Version Version

Contact Preference

Do we have permission to leave you a voicemail?

YES NO

Confirm All Booking Details

Appointment Location
Appointment Time
Province
Health Card Number
Health Card Version

Complete Step 2

Thank you for registering with us

If you booked an appointment, you will receive an email from our clinic partner.

We will wait for your documents to be sent from your Health Care Practitioner

Please send your medical document to your health care practitioner. Once we receive it from them, we will process your registration.

Lot Identification:
Production Facility:

Lot Release Date:
Cold Pasteurized:

Register with Starseed

Get Medical Document

Get Approved & Start Shopping

First let’s create your account

Let us know a bit more about yourself

I am completing this application

Caregiver #1 Information

Would you like to add another Caregiver?

Caregiver #2 Information

Add Your Address

Find Your Address

Finish your Address

Address Contact

Address

Practitioner Information

Are you a part of an Employer Program / Union?

Which Employer Program / Union and Local are you part of?

Please confirm the following:

Please Confirm Your Benefits Plan Information

What is your member number?

Do you have your own insurance?

Do you have Medical Cannabis Coverage?

My Insurance Details

Are you a Veteran?

What is your Veteran K Number?

Thank you for registering with us!

Complimentary At Home Consultation

Instruction for your Health Care Practitioner

Connect to Healthcare Professional

Select One of the following options:

Instruction for your Health Care Practitioner

1. Download forms & Complete with health care practitioner.

2. Send us your completed forms

You Must Connect to a Medical Doctor

Select appointment type

Select Location

Closest Available Time Slots

Appointment Calendar

Enter health card

Confirm All Booking Details

Complete Step 2

Thank you for registering with us

We will wait for your documents to be sent from your Health Care Practitioner

Step 3-1 starts here

Step 3-2 starts here

Step 3-3 starts here

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About

Welcome to Starseed

Year of Birth

Quality Assurance Report

Total Bacteria PASS

Total Yeast and Mold PASS

Bile-Tolerant Gram-Negative Bacteria PASS

E. coli PASS

Salmonella PASS

Total Aflatoxins (B1, G1, B2, G2) PASS

Heavy Metals PASS

Moisture Content PASS

Visual Inspection PASS

Full Pesticide Test Report

2,4’-DDD PASS

2,4’-DDE PASS

2,4’-DDT PASS

4,4’-DDD PASS

4,4’-DDE PASS

4,4’-DDT PASS

Alachlor PASS

Aldrin PASS

α-BHC PASS

β-BHC PASS

σ-BHC PASS

Azinphos-Ethyl PASS

Azinphos-Methyl PASS

Bifenazate PASS

Bifenthrin PASS

Bromophos-Ethyl PASS

Bromophos-Methyl PASS

Brompropylate PASS