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Thank you for signing up with

Dr. Samuel Brayfield, D.O.

Over 34 years of experience as a medical practitioner, with experience ranging from pediatric to adult and geriatric medicine. Dr. Brayfield has established himself as a palliative care specialist, additionally, specializes in hospice care.

Tel: (573) 480-0045

drbrayfield@moondancemedical.com

* Phone is answered 9AM-4PM Monday thru Thursday, and 9AM to 2PM on Friday.

Leave a voice message if no answer.  Dr Brayfield will contact you to schedule an appointment

Now please answer questions about yourself and your medical condition. Our doctors use this information in order to learn more about you before your doctor's evaluation.  After the doctor reviews your evaluation, you will be notified by your preferred method of communication to schedule your appointment or to notify you that you did not qualify.

For an Online Appointment, you'll need:

 

  1. Good connectivity

  2. Laptop, desktop or Smartphone, with camera

  3. At least average computer skills to be able to download, upload, print, send and receive email attachments

If not I strongly suggest you request an in office appointment with Dr Gina Carter or have someone with good computer skills help you.

Using the Laptop
Image by Maxim Potkin

These steps are a prerequisite to your appointment confirmation:

  1. The doctor will send a DocuSign agreement (Medical Marijuana Release Form) that you can easily fill out on your screen. Read each category, initial where indicated, sign and date at the end.

  2. Register on the Missouri Medical Marijuana Program (MMMP) website. Email or text me the User Name (your email) and Password as I need these to complete your application (click here).

  3. ID pictures needed: Text or email me:

  • Selfie

  • Front of you MO drivers license 

  • Back of your MO driver's license. Make sure pics are close up, centered and in focus

Pricing:

Charges: Include: video consultation, filing Physician Certification and filing Patient Application and any follow up to address problems or questions.

  • New patient: $150

  • Renewal: $100

  • Caregiver license $25

  • Caregiver renewal $25

I will take your credit or debit card at the completion of the consultation. There is a $3 service fee for cards.

10% discount for US Veterans

Image by CardMapr