Marijuana Facts
Colorado Medical Marijuana Registry Application Instructions
Instructions for applying for a Medical Marijuana Registry Identification Card
You must complete the Registry application form and ask your physician to complete the Physician Certification form. If the applicant is a minor or you have more questions, please contact the Registry at 303.692.2184. Before sending materials, please make sure your application packet is complete. Incomplete applications will be returned to the applicant. Whiteout and cross-outs will void this form.
APPLICATION FOR IDENTIFICATION CARD
* Please, legibly complete the entire application form.
* You may choose to designate a caregiver or a Medical Marijuana Center, although you do not have to.
* Complete the physician information.
* Sign and date in front of notary, and have notarized. The date of the patient's and the notary's signatures must be the same. The notary can not be the patient, caregiver or the physician.
* PHYSICIAN CERTIFICATION
* Your physician must complete and sign the physician certification form.
* Only an MD or DO licensed in good standing to practice medicine in the state of Colorado may sign this form.
* The Registry must receive your complete application within 60 days of the physician's signature.
* A LEGIBLE PHOTO COPY OF A PHOTO ID THAT ESTABLISHES COLORADO RESIDENCY FOR THE PATIENT AND
CAREGIVER (if designated) (driver's license, state ID) See below for other options. Broken or tampered ID's are not valid.
* NON-REFUNDABLE $90.00 APPLICATION FEE (check or money order payable to CDPHE) We do not accept temporary checks and make sure the form of payment is signed. Please write the patient's name on the check. The notary cannot sign the form of payment.
SUBMIT ALL ITEMS
We recommend you send your paperwork by certified mail to:
Colorado Department of Public Health and Environment Medical Marijuana Registry or MMR
4300 Cherry Creek Drive South
Denver, CO 80246-1530
DROP OFF BOX: Colorado Department of Public Health and Environment
710 S. Ash Street, South East Entrance Inside the first set of glass doors will be a Drop Box for MMR applications. Doors open: Monday-Friday, 7:00 a.m. to 6:00 p.m. Your application must be in a sealed envelope. You will not receive a receipt. If you wish to have a receipt, please mail in your application by certified mail.
The Registry is not affiliated with any privately operated club, organization, or dispensary.
* Incomplete applications will be returned to the applicant.
* The date the patient signs and the physician signs do not have to be the same.
* Keep copies of all the documents you submit to the Registry. The law states
*patients must reside in Colorado and submit the completed application
form adopted by the State Health Agency.
* No one is permitted to submit paperwork to the Registry except the patient. For proof that your application has been submitted, you may want to send your application in by certified mail.
* The applicant will receive one card with the patient's information and caregiver information, if designated.
* Please check our web site to find the latest time estimate for processing applications.
* Available Primary Care-givers: The Registry will be accepting the names of individuals who would like to be a primary care-giver and have authorized the
Registry to release their contact information to patients in search of a primary care-giver. This is an optional service for those patients having difficulty
finding a primary care-giver. Please check our web site for the availability of this option. Once this service is available, a Request for Primary Care-giver List form will be posted.
For more information, please visit: www.cdphe.state.co.us/hs/medicalmarijuana All Documents must be currently valid! At least one of these documents must show the applicant's date of birth.
At least 1 of the following
Colorado Driver's License
Colorado ID
Temporary Colorado Driver's License
Temporary Colorado ID
Or at least 2 of the following
Minimum of 1 from the group of ID's below -
Out of State Driver's License
Out of State ID
Passport, Military ID, Tribal ID
And a Minimum of 1 from the group below -
Colo Work Identification/paycheck stub/W-2
Utility bill, medical/insurance bill or cable bill
The above items must show a Colorado residence
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