Book a Consultation

To be eligible to book an appointment, we require the following form to be submitted.

If you do not have time to complete this now, we have sent this to your email to complete at your earliest convenience

First Name(Required)
State/Region(Required)
DD slash MM slash YYYY
What are the main chronic (lasting more than 3 months) health conditions you aim to consult about? Please list no more than 2-3.
Please list all investigations that were carried out by your healthcare provider(s) for the conditions listed above. Investigations may include: x-ray, ultrasound, blood tests. If none, please write NA.
● Please list all medications (prescribed/ceased prescribed, past and present, over the counter) that you have taken for your chronic condition(s).
● Explain which ones helped with your condition(s) and which ones didn't help. If none, Please write NA.
Do you have any personal history of unstable heart disease (e.g, past heart attack) or recent hospitalization?
Family or Personal History of Schizophrenia/Psychosis/bipolar/Suicidal Attempts/Ideation?(Required)
● Do you or does anyone in your family have a history of schizophrenia/psychosis/bipolar?
Do you have any allergies?*(Required)
Your experience with cannabis (if any) helps your doctor to understand and formulate a treatment plan that best suits you.
● If you currently have a prescription, please tell us which prescription you have (what works and doesn’t) and clinic/doctor you are currently seeing?
● If not already prescribed, type NA. *If you become a patient of Telegreen you understand you cannot have more than 2 medical cannabis clinics managing your medical needs simultaneously* (TGA regulatory compliance)
Do you suffer from any illicit substance dependence or is on a opioid treatment program (OTP)?*(Required)
Females only
● If prescribed natural therapy, do you acknowledge to take contraception or other reasonable methods to prevent pregnancy and/or cease treatment if pregnant or Breastfeeding
Consent for Unapproved Medicines (Medicinal Cannabis)
● “Medicinal cannabis is an unapproved medicine. By agreeing to TelegreenMedical’s Consent for Unapproved Medicines before this consultation, you provide consent to be prescribed an unapproved medicine (if deemed suitable) and acknowledge the associated risks, restrictions, and possible complications outlined below.
● You will be asked this again during your initial consultation to confirm that you understand this by saying ‘Yes.’ Your verbal agreement will be documented by the HCP as secondary confirmation of your consent to be prescribed an unapproved medicine.”
● Benefits, Risks, Restrictions, and Possible Complications of Medicinal Cannabis
● By signing this document, I acknowledge that I understand and agree to the following:
● I understand that the quality, safety, and efficacy of medicinal cannabis have not been assessed by the Australian government’s Therapeutic Goods Administration (TGA). As a result, access to medicinal cannabis is only available through a Special Access Scheme (SAS), Authorised Prescriber Scheme (AP), or Clinical Trial pathways under the TGA Goods Act 1989.
● I acknowledge that unapproved medicines, including medicinal cannabis, are generally considered experimental, with limited data to inform specific treatment recommendations. For more information, I can visit the TGA website: www.tga.gov.au/medicinalcannabisguidance-documents.
● I understand that the long-term side effects of medicinal cannabis are unknown, and I may experience negative or unwanted side effects.
● I agree to follow my doctor’s recommendations regarding dosing and report any adverse effects to my healthcare team, including but not limited to sedation, lethargy, fatigue, dry mouth, nausea, vomiting, diarrhea, drowsiness, dizziness, disorientation, agitation, balance problems, memory changes, paranoid delusions, or hallucinations.
● I understand that medicinal cannabis may interact with other medications I am taking, and adjustments to my treatment may be necessary.
● I agree to follow any recommendations for blood tests or additional investigations related to my medicinal cannabis treatment.
● I understand that alcohol, intoxicants, or recreational drugs may interact with medicinal cannabis treatment and affect my health.
● I waive and disclaim any rights to claim against TelegreenMedicals for any potential side effects, adverse effects, or unknown risks related to medicinal cannabis use.
● I understand that the cost of medicinal cannabis, if prescribed, is my responsibility and is not covered by government programs such as the Pharmaceutical Benefits Scheme (PBS).
● I acknowledge that driving or operating a motor vehicle, tram, train, or vessel with delta-9tetrahydrocannabinol (THC) in my system is illegal, and I am responsible for being aware of specific laws in my State or Territory. A prescription does not provide a defense for these offenses.
● I agree to refrain from driving or operating heavy machinery while using THC and understand that doing so may violate the law.
● I agree to keep a log of my doses and any changes in symptoms due to medicinal cannabis use.
● I agree to attend regular follow-up consultations, either in the clinic or over the phone, as directed by my healthcare provider.
● I understand that sharing, selling, lending, or giving away my medicinal cannabis is illegal, and I acknowledge that my healthcare provider or pharmacist may work with law enforcement or government authorities to investigate any alleged misuse.
I acknowledge that I have read and understood the consent stated above to the best of my knowledge.
Telegreen Medical is committed to protecting and respecting your privacy, and we’ll only use your personal information to administer your account and to provide the products and services you requested from us. From time to time, we would like to contact you about our products and services, as well as other content that may be of interest to you. If you consent to us contacting you for this purpose, please tick below to say how you would like us to contact you:
Consent
You can unsubscribe from these communications at any time. For more information on how to unsubscribe, our privacy practices, and how we are committed to protecting and respecting your privacy, please review our Privacy Policy.
By clicking submit below, you consent to allow Telegreen Medical to store and process the personal information submitted above to provide you the content requested.
This field is for validation purposes and should be left unchanged.

"Telegreen Medical changed my life for the better."

“After years of chronic pain and stress, Telgreen Medical provided the care and treatment I needed. Their holistic approach made all the difference—I finally feel like myself again!”

Sarah L., Telgreen Medical Patient

Telgreen Medical – Here for You, Every Step of the Way

Follow-Up

Privacy Policy

Join Our Team

Medication Return

About Telegreen Medical

Booking Policy & Patient Consent

+61 484528550

[email protected]

Sydney, NSW

We acknowledge the Traditional Owners of the land where we work and live. We pay our respects to Elders past, present, and emerging. We celebrate the stories, culture, and traditions of Aboriginal and Torres Strait Islander Elders of all communities who also work and live on this land.

Disclaimer: Telgreen Medical does not advocate for the use of unapproved botanical medicine by the Therapeutic Goods Administration (TGA). Reactions to these treatments can vary, and effectiveness is not guaranteed for all. Consult your healthcare provider regarding these options. In Australia, the governance and regulation of unapproved botanical medicine fall under the TGA. For the latest information, visit the TGA’s official website.
Copyright © 2024 Telgreen Medical