Application For Medical Marijuana Card - Colorado Medical Marijuana Registry
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Application for Medical Marijuana Card
Before submitting your Application packet to the Registry, make copies for your personal records.
Applications must be mailed in by the patient or legal guardian.
New and Renewal Adult Applicants must submit:
A complete application form (AP)
A physician certification (PC) form completed by an MD or DO licensed to practice in Colorado
A copy of your Colorado driver’s license or photo ID (or a Proof of Identity and Residency Waiver (PW))
A completed caregiver agreement (CA) (if applicable)
A $15 check or money order (non-refundable application processing fee) made out to CDPHE (or a Fee Waiver
Form (FW))
Renewal applicants:
,
To avoid a lapse in your registration period
please submit your application at least 30 days
before your card expires. Note: Renewal applications CANNOT be used to purchase medical marijuana.
Legal Guardians and Legal Representatives must submit:
A complete application form (AP)
A physician certification (PC) form completed by an MD or DO licensed to practice in Colorado
A copy of the patient’s Colorado driver’s license or photo ID (or a Proof of Identity and Residency Waiver (PW))
A copy of your Colorado driver’s license or photo ID
Legal guardianship documentation (ie. court issued orders or medical power of attorney)
A $15 check or money order (non-refundable application processing fee) made out to CDPHE (or a Fee Waiver
Form (FW))
Note: Medical care rights and or health care decision authority must be legally assigned in order for you to sign on
behalf of the patient.
Minor Applicants must submit:
A complete application form (AP)
A Parental Consent form (MC) for parents/guardians residing in Colorado
Two (2) physician certifications (PC) completed by two (2) MDs or DOs licensed to practice in Colorado
A certified copy of the minor’s state-issued birth certificate (or legal guardianship order)
A copy of both parent’s/legal guardian’s Colorado driver’s licenses or ID’s (or a Proof of Identity and Residency
Waiver (PW))
A $15 check or money order (non-refundable) made out to CDPHE (or a Fee Waiver form FW))
New Colorado Residents:
If you have recently moved to Colorado the fastest way obtain a medical marijuana card is to obtain a Colorado
Driver’s License or ID prior to applying for a medical marijuana card.
Proof of Residency Waivers can be requested if you are a first time applicant who can demonstrate a substantial
need and provide a valid reason why you are unable to obtain a Colorado Driver’s License or ID. If you choose to
request a waiver, your application will go through a waiver review which will add 2 or more weeks to your
application processing time. Proof of residency waivers are only granted once.
Mail Application packet to:
Application Processing, CDPHE HSV-8608, 4300 Cherry Creek Dr S, Denver, CO 80246-1530
Processing time:
Please allow 3-5 weeks from the date the Registry receives your application packet for standard processing. If you do
not receive your card or a letter from the Registry within 35 days, please contact us at 303-692-2184.
4300 Cherry Creek Dr S, HSV-8630, Denver, CO 80246 | 303-692-2184
medical.marijuana@state.co.us
|
MMR1001 Application | Revised October 2016
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Parent category: Medical