Given name is required
Surname is required
Please provide valid (MM/DD/YYYY) date of birth
Valid email is required
Invalid phone #, format should be 1(xxx)xxx-xxxx
Invalid number
Required
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When applicable, make sure to include complete Civic/Street address, SITE, COMP, PO BOX, RR, GD and STN/RPO.

See Canada Post Addressing Guidelines for more information.

Physical Address
Address is required
Address is required
City is required
A choice is required
Valid postal code is required, 6 characters with following pattern "A9A9A9"
Mailing Address
Address is required
City is required
A choice is required
Valid postal code is required, 6 characters with following pattern "A9A9A9"
Shipping Address
Address is required
City is required
A choice is required
Valid postal code is required, 6 characters with following pattern "A9A9A9"
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A caregiver is a designated person who is responsible for the patient and/or applying on behalf of the patient.

Important: caregiver must be physically present to complete registration.

Primary Caregiver
Given name is required
Surname is required
Please provide valid (MM/DD/YYYY) date of birth
Required
Valid email or phone is required
Valid phone or email is required, format should be 1(xxx)xxx-xxxx
Caregiver #2
Given name is required
Surname is required
Please provide valid (MM/DD/YYYY) date of birth
Required
Valid email or phone is required
Valid phone or email is required, format should be 1(xxx)xxx-xxxx
Caregiver #3
Given name is required
Surname is required
Please provide valid (MM/DD/YYYY) date of birth
Required
Valid email or phone is required
Valid phone or email is required, format should be 1(xxx)xxx-xxxx
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If you have your medical document on hand, please upload it now. You may still continue with the application online, however, ensure your health care practitioner faxes your medical document to toll free: 1-877-226-5909. Alternatively email to care@zyus.com

If you have a scan of your veterans Blue Cross card or any other relevant documents you may upload now.

Medical Document
Veteran's Blue Cross Card
Additional Documents
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  • The applicant acknowledges that cannabinoids have not been approved for use as a drug in Canada, that its indications, safety and risks have not been adequately studied and the appropriate dosage is unclear.
  • The applicant acknowledges and agrees that he or she is using any cannabinoid product obtained from ZYUS Life Sciences Inc.(ZYUS) at his or her own risk and releases ZYUS, its affiliates, providers, directors, officers and employees from any and all actions, claims, complaints and demands for damages, loss or injury whatsoever arising directly or indirectly as a consequence of the use of cannabinoids obtained from ZYUS.
  • The applicant ordinarily resides in Canada.
  • The information in this application and medical document or registration certificate is correct and complete.
  • The medical document has not, to the knowledge of the applicant been altered.
  • The medical document is not being used to seek or obtain cannabinoids from another source.
  • The applicant intends to use any cannabinoid products supplied to them on the basis of this application only for their own medical purposes.
  • The applicant consents to ZYUS’ collection, use and disclosure of personal information contained in this patient registration form, medical document or registration certificate (if applicable), in order to complete registration of the applicant and communicate with the healthcare practitioner named in the medical document, licensing authorities and ZYUS’ service providers, in accordance with ZYUS’ privacy policy and applicable laws.
  • If the applicant has a specified K number on this application, the applicant consents to ZYUS sharing personal details and information contained in this application with Veterans Affairs Canada or the applicant’s insurance provider.
  • The applicant consents and permits ZYUS to send product and registration information to the physical addresses identified in the patient registration form, and communicate with the applicant via email regarding registration status, product availability, order status, and other matters in accordance with ZYUS’ privacy policy.
Required
Valid signature required
Sign with finger or mouse above
Sign with finger or mouse above
Valid signature required
Sign with finger or mouse above
Valid signature required
Sign with finger or mouse above
Valid signature required
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A ZYUS team member will be in contact with you at .

An email has been sent to . Please follow the instructions in the email to complete your registration.

Registration: 3 Easy Steps

It can be challenging to find the best therapeutic option for you. Whether this involves experiencing symptoms or suffering from side effects from current treatments, it can be difficult to get through the day, let alone engage in day-to-day activities. We encourage patients and healthcare practitioners to work together and discuss the benefits and risks of cannabinoids to determine the ZYUS formulations best suited for patient needs.

To ensure cannabinoids are easily accessible, we strive to make the registration process as simple and comprehensive as possible

Application

First time patients - Complete the application document online or complete the downloadable Application (PDF) if you currently reside in a hostel, shelter, hospice or similar institution.

Returning or Renewal Patients - Please log in to your account for your easy renewal and as always you can contact patient care, we're here to help!

Please contact our Patient Care Team with any question or concerns. We're here to help.

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If you choose to complete the downloadable forms, here is how to send the documents to ZYUS:

  • Secure fax: 1-877-226-5909
  • Email: care@zyus.com
  • Registered Mail:

    ZYUS
    Patient Care
    204 - 407 Downey Road
    Saskatoon, SK S7N 4L8

Please be advised we only accept original documents, not photocopies or scanned copies if sending via registered mail


Registration Changes and Updates

Patients may use the Application to Amend Registration Form to update and make changes to the original application.


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Registration Renewal

Returning or renewing your registration with ZYUS - Please log in to your existing account for quick renewal and ensure to visit with your health care provider to submit a new medical document.

Already Registered?

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