Medicinal Cannabis for Chronic Non Cancer Pain (CNCP) request form

For Medical  Practitioners - This form must be completed for all requests of medicinal cannabis to treat chronic non-cancer pain (CNCP).

Complete in full and provide copies of all relevant documents. The TAC cannot consider requests for medicinal cannabis without the full completion of this form.  If a Pain Specialist is not involved in the patient’s pain management, we are unable to consider funding this request.