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Medical Marijuana Program Homepage
Appeals Process
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Responsibilitites:  Applicant, Primary Caregiver, and Physician
Responsibilities:  State and County
Verify Validity of Medical Marijuana Identification Card Number
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Medical Marijuana Program
Forms

Application / Renewal Form - DHS 9042 (English Version / Spanish Version)

Denial Appeals Application - DHS 9043 (English Version / Spanish Version)

Written Documentation of Patient’s Medical Records - DHS 9044 (English Version / Spanish Version)

Monthly Remittance Form - DHS 9045 (English - For Administering Agency Use Only)

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