Physician Referral Program | Releaf MD

Coordinating Care for Complex Cases

At Releaf MD, we understand that medical cannabis represents an adjunctive therapy for many chronic, debilitating conditions. We work closely with primary care physicians, oncologists, pain management clinics, and psychiatrists across the Tampa Bay area to coordinate care. Our goal is to provide a safe, physician-monitored option for patients seeking alternative symptom management.

How to Refer a Patient for Medical Marijuana in Florida

We maintain rigorous clinical standards to ensure that patients are evaluated responsibly. If you are a licensed physician wishing to refer a patient, please follow our standard referral steps:

Provide Medical Records: Securely fax or email the patient's diagnostic notes, pathology reports, list of active prescriptions, or clinical summaries indicating their qualifying diagnosis.
Complete the Referral Form: Submit the patient's basic contact details via our clinical portal, or instruct the patient to contact our office directly at 813-651-3492.
Clinical Consultation: Dr. Kelly Ennix King performs the state-mandated in-person evaluation, reviews the referral documentation, and enters the appropriate recommendation orders.

Committed to Professional Ethics

Releaf MD does not sell cannabis products and is not a dispensary. We focus solely on clinical medical evaluations, dosage guidelines, and patient registry support. We provide diagnostic summaries back to referring offices to ensure continuity of care.

Why Physicians Partner with Releaf MD

Medical practices trust Releaf MD because of our transparent, physician-led approach:

Assessment led by Dr. Kelly Ennix King, an experienced physician and Air Force veteran.
Compliance-first patient registry profiles and documentation.
Individualized dosing recommendations tailored to minimize pharmaceutical interactions.

Patient Referral Form

Please complete the secure referral form below to refer a patient to Releaf MD. Submitting this form alerts our intake coordinator. To send clinical documentation and diagnostic records, please fax them securely to 813-651-3493 or email securely using encrypted mail to records@releafmd.com.

1. Referring Provider Details

Doctor / Practice Name

NPI Number

Contact Email

Phone / Fax

2. Patient Details

Patient Full Name

Patient Date of Birth

Patient Phone

Patient Email (Optional)

3. Clinical Referral Information

Primary Diagnosis / Qualifying Condition

Clinical Notes & Dosing Considerations

HIPAA Compliance & Privacy Acknowledgment: I certify that this referral is made in accordance with clinical guidelines. Patient consent has been obtained where required. The information provided here will be transmitted securely and kept confidential in accordance with HIPAA standards and Florida Statute 381.986.