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Prepare your PT33 print it for review

Fill the official form, check the preview, and print or save a PDF for your practitioner to review and sign.

PT33 form details

For authorized practitioners and staff preparing their paperwork. Clinical findings and quantities must come from the practitioner’s assessment. This tool does not issue a prescription or verify a licence. Signature lines stay blank for signing.

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1. Fill form2. Review & print

Printed form language

1. Prescribing practitionerIssue date, name, profession and licence

Issue date (Gregorian year)Practitioner’s full nameProfessionLicence / certificate numberPractitioner addressAddress, continued (optional)

2. Patient detailsName, age, nationality and ID

Patient’s full nameAge (years)NationalityThai ID / passport number

3. Practitioner’s treatment detailsClinical findings, daily grams and duration

Condition / symptomsCondition / symptoms, line 2 (optional)Condition / symptoms, line 3 (optional)Prescribed grams per dayTreatment days (1–30)Total prescribed (grams)—Calculated from grams per day × treatment days.

PT33 previewOpen blank official PDF ↗

Check every field before printing. The patient and authorized practitioner must sign the printed form. An unsigned form is not an issued prescription.

Need a medical assessment?

A practitioner decides whether treatment is appropriate. Patients can request an assessment with Cannabox MD; approval is not guaranteed.

Request a medical assessment ↗

PT33 field-by-field guide →Need PT27 or PT28? →Official DTAM guidance ↗

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