Steps to Certification

The following are the Steps to Certification:

1. Proof of Massachusetts Residency:

  • Driver’s license OR
  • Massachusetts State ID OR
  • Passport with proof of residency i.e. utility bill, lease, etc. in your name

2. Medical Records

Medical Records should be from a physician(s) or therapist(s) and state a debilitating condition that is active and for which you are receiving treatment. Records should be from within the past two years.

Here is a Medical Release Form to provide to your phyician to obtain records directly or have them faxed to us at 413-391-7489.

We accept:

  • Office visit notes re: diagnosis/treatment (within past two years) OR
  • Current Active Problem List (date specific) OR
  • Letter from treating physician attesting to ongoing treatment for specified condition.
  • Medication lists/notes/sheets (optional).

We do not accept:

  • Any records older than two years.
  • MRI’s/X-Rays/CT scans/EKG’s.
  • Blood/Lab work.
  • Surgical Reports.
  • Hospital visit records.
  • School Reports.
  • Insurance Claims.
  • Medical bills.

3. Medical History Intake Form:

Print and fill out this Medical History Intake Form and bring it to your scheduled appointment (or arrive 15 minutes early to complete).

4. Call MariMed Consults at 413-455-1081 to schedule an appointment. We look forward to seeing you.


MariMed Consults

Northgate Professional Center, 1985 Main Street, Suite 209, Springfield, MA 01103
Phone: 413-455-1081
Fax: 413-391-7489

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