Download a Release Form

Your Medical Records Are Safe With Us

In order for MMCS Clinic to assist you in obtaining a medical marijuana card, please print out and complete our Medical Records Release Form (below):

Click here to download MMCS Clinic’s Medical Records Release Form

Your completed medical records release form should then be given to your doctor’s medical records department, who will send send your records to MMCS Clinic for review. This process usually takes about a week, but sometimes can take up to 30 days. You may also get a copy of your medical records from your doctor and bring them with you to your appointment for us for review.

Your doctor will not know that you are applying for a medical marijuana card. It is your right to disclose this information to your doctor or not. MMCS will not release your patient information unless you fill out a medical record release form to release your information to the organization of your choice.

After MMCS Clinic receives your medical records, we’ll contact you to arrange the pre-payment of our $35 medical record review fee, which goes towards the total cost of your appointment. After you’ve settled the pre-payment fee, we will schedule you an appointment to see the doctor.

If you would like staff to send your medical records release form to your doctor’s office for you, please print out and completed the form and then visit MMCS Clinic during business hours, and we will fax the form to your doctor’s medical records department.

You can also mail or fax your completed medical records release form to us to process for you:


MMCS Clinic – Medical Records Department
4911 NE Sandy Blvd.
Portland OR 97213



Have questions? Feel free to call us at 503-384-WEED (9333) for help.