Name Username* First Name* Last Name* Social Please list your Instagram or FacebookContact Info Phone # Please list the best phone number for text & calls E-mail* Password* Repeat Password* Website About Yourself A Little About You Give us a little info on what you are looking for. Rosin? Capsules? Pain Relief? Sleep Aid? etc...Type of MembershipPlease choose which type of client you are:Wholesale - FreeThis is for Caregivers or Shops who want to work together and get wholesale pricingPatient - FreeOur Patient Direct ProgramMedical or Caregiver Card*Please upload your current medical card or Caregiver Card to activate your accountDrivers License*Please upload your drivers license to verify your medical card I Agree*By clicking here I agree to allow Roxi Gray LLC review all my data to become a member of their services.Send these credentials via email.
