Are you eligible?

What type of condition are you seeking treatment for?

This form is NHS Data Security Compliant. Your data will be used exclusively by CB1 Medical to determine eligibility and will not be shared with any other party.

Are you eligible?

Are you over 18 years old?

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This form is NHS Data Security Compliant. Your data will be used exclusively by CB1 Medical to determine eligibility and will not be shared with any other party.

Are you eligible?

Have you been prescribed at least two other treatments for your condition?

YesNo

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This form is NHS Data Security Compliant. Your data will be used exclusively by CB1 Medical to determine eligibility and will not be shared with any other party.

Are you eligible?

Are you pregnant or breastfeeding?

YesNo

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This form is NHS Data Security Compliant. Your data will be used exclusively by CB1 Medical to determine eligibility and will not be shared with any other party.

Are you eligible?

Have you ever been diagnosed with Schizophrenia, Psychosis or Bipolar Disorder?

YesNo

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This form is NHS Data Security Compliant. Your data will be used exclusively by CB1 Medical to determine eligibility and will not be shared with any other party.

Unfortunately, you are not eligible for our treatment

The information you’ve provided indicates you are unlikely to be eligible for a consultation. Please get in contact if you would like to discuss your situation further.

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You are eligible!

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This form is NHS Data Security Compliant. Your data will be used exclusively by CB1 Medical to determine eligibility and will not be shared with any other party.