Book Your Cannabis Rescue Session

Step 2 of 3

Patient Intake Form

Help Gil prepare for your session. The more detail you provide, the more precise your Titration Map will be.

Full Name *

Please enter your full name.

Email *

Please enter a valid email address.

Phone / WhatsApp Number * Include country code, e.g. +1 555 123 4567

Please enter your phone or WhatsApp number.

Country *

Please select your country.

What condition(s) are you treating with cannabis? * e.g. chronic pain, PTSD, insomnia, anxiety, fibromyalgia, etc.

Please describe your condition(s).

What cannabis products are you currently using? * Strain names, formats (oils, flower, vape, edibles), THC/CBD ratios if known

Please list your current cannabis products.

Current dosing routine — what, when, how much? * Be as specific as possible: product, time of day, amount

Please describe your current dosing routine.

How long have you been using medical cannabis? *

Please select how long you've been using cannabis.

What's not working? What made you seek help? * This is the most important question. Take your time. Be honest.

Please describe what's not working and why you're seeking help.

Do you have a prescribing physician? *

Yes No

Please indicate if you have a prescribing physician.

Anything else Gil should know before your session? Optional — previous treatments, allergies, medications, etc.

I understand this is clinical cannabis coaching, not a medical prescription. All product changes should be discussed with my prescribing physician. *

You must agree to this before proceeding.

Step 3 of 3

Complete Payment

Review your booking details and pay securely via PayPal.

Booking Summary

Cannabis Rescue Session with Gil Luxenbourg

Patient

Date & Time (Your Time)

Date & Time (Israel)

Duration 90 minutes

$250

Cannabis Rescue Session — includes written Titration Map

✓

You're Booked!

Your Cannabis Rescue Session has been confirmed. Gil is already preparing for your consultation.

Session Cannabis Rescue Session (90 min)

Date/Time

Patient

Transaction

Next steps: Gil will send you a personal confirmation and Zoom link within 24 hours to gil@isitweed.com. Check your email for details.

If you don't receive confirmation within 24 hours, click here to email Gil directly with your booking details.

Choose Your Session Time

Patient Intake Form

Complete Payment