Renew Please complete this short form so we can assist you in renewing your Alaska medical marijuana card.Choose All Medical Conditions That Apply to YouGeneral Conditions Severe Pain Nausea Muscle Spasms Seizures CancerSpecific Conditions Cachexia Multiple Sclerosis Glaucoma HIV+/AIDS Alzheimer'sNone I suffer from NONE of the above conditionsYou have indicated that none of the above conditions apply. However, this may not be true.Take a look through the detailed conditions below and make sure that none apply to you.Don't be afraid to check the "OTHER" box if you are just not sure.You have indicated that you are suffering from "Severe Pain".Please help us narrow down your condition by choosing a more specific item below.Don't be afraid to check the "OTHER" box if you are just not sure.Severe Pain Arthritis Chronic Pain Syndrome Colitis – Ulcerative Chronic Back Pain Degenerative Joint Disease (DJD) Degenerative Disc Disease (DDD) Fibromyalgia Gout GERD (Reflux) Herniated Disc Irritable Bowel Syndrome (IBS) Lumbar Stenosis Lumbago Lupus w/ Joint Involvement Migraine Headaches Neuropathy Plantar Fasciitits Ruptured Disc Radiculopathy Spinal Stenosis Spondylosis Spina Bifida Scoliosis Severe Peptic Ulcers Severe Joint Pain TMJ Trigeminal NeuralgiaOTHER Severe Pain Condition OtherPlease Describe Your Exact Severe Pain Condition*You have indicated that you are suffering from "Nausea".Please help us narrow down your condition by choosing a more specific item below.Don't be afraid to check the "OTHER" box if you are just not sure.Nausea Chemotherapy Diverticulosis Irritable Bowel Syndrome (IBS) Medical Associated Nausea Meiner's Disease Nephropathy Peptic Ulcers Radiation Therapy Sprue VertigoOTHER Nausea Condition OtherPlease Describe Your Exact Nausea Condition*You have indicated that you are suffering from "Muscle Spasms".Please help us narrow down your condition by choosing a more specific item below.Don't be afraid to check the "OTHER" box if you are just not sure.Muscle Spasms Chronic Back Pain Charcot-Marie-Tooth Disease Limb Trauma Movement Disorder Nocturnal Leg Cramps Parkinson’s Disease Restless Leg Syndrome Tourette’s syndrome Spasticity ConditionOTHER Muscle Spasm Condition OtherPlease Describe Your Exact Muscle Spasm Condition*You have indicated that you are suffering from "Seizures".Please help us narrow down your condition by choosing a more specific item below.Don't be afraid to check the "OTHER" box if you are just not sure.Seizures EpilepsyOTHER Seizure Condition OtherPlease Describe Your Exact Seizure Condition*You have indicated that you are suffering from "Cancer".Please help us narrow down your condition by choosing a more specific item below.Cancer Bladder Breast Colon Rectal Endometrial Kidney Leukemia Lung Melanoma Non-Hodgkin Lymphoma Pancreatic Prostate ThyroidOTHER Type of Cancer OtherPlease Describe Your Exact Cancer Condition*Name* First Last Email* Enter Email Confirm Email Zip Code*Phone*I am interested in more information about... Weekly Newsletters Dispensaries New Product Information Volunteering Finding a Grower Growing for Other Patients My Medical Condition Participate in Clinical TrialsPhoneThis field is for validation purposes and should be left unchanged.
