Make an appointment with your physician and take in a copy of the physician form.

Your physician will need to complete the Physician Written Certification Form and mail it from their
office to the IDPH – Division of Medical Cannabis as the address on the form states.

The certification must be received within 90 days of your portion of the application and show an
in person appointment within the last 90 days.

It is generally a good idea to bring along a copy of your medical records to your appointment
showing diagnosis or treatment of the qualifying condition.

Fingerprints must be completed within 30 days of your application submission.

The Fingerprint Consent form (a page found in the application form) must be filled out and taken to
the fingerprint vendor at the time of fingerprinting. The TCN # needs to be filled in by the fingerprint
administrator.

The cost of finger printing is usually around $60.

Certified Live Scan Fingerprinting locations: IDFPR.com/LicenseLookUp/fingerprintlist.asp

You can call and request a paper application if necessary. Call the Medical Cannabis Registry Program at
1-855-636-3688 and request a paper application. If you wish to apply for a one or two year card, as opposed to the
standard 3 year online application, the paper version of the application is required.

You should start to gathering and filling out your documents BEFORE you begin the application process.
Application Form: http://dph.illinois.gov/sites/default/files/forms/medicalcannabis-qualifying-patient-application-091916.pdf
Application Form Instructions: http://dph.illinois.gov/sites/default/files/forms/formsohpm11.23.16medicalcannabis
qualifyingpatientapplicationinstructions.pdf

You will need:

• Proof of residency
• Proof of identity
• Passport photograph – 2” x 2” photo (Minimum size of 600 x 600 pixels)
• Fingerprint consent form (found with the application forms)
• Choose a dispensary in your area.
• Any caregiver who will need a card to assist you in obtaining products from the dispensary
  should also apply. Application Form: Bit.ly/CareGiverApplication

Have all of these forms ready when you start your application. For online applications, you will need to have scanned
digital files for submission.

If you are on SSI or SSDI you will need to submit a “Benefit Verification Letter” from the Social
Security Administration that states your address and type of benefits that are received.

The letter must be dated within the last year.
Go to SSA.gov/myaccount/ to get the letter through your Social Security account.

To apply for a 3 year card create an account MedicalCannabisPatients.Illinois.gov

You can submit your information, forms and necessary paperwork through this account.

Keep your answers short and simple.

Fill in all required fields.

Be sure to submit your whole application at the same time with all of the necessary paperwork.
This will speed up the process of approval.

Fees will be paid online at this point.

After all documents have been submitted, you will usually receive your card within 30-45 days.
You can check on the status of your application AFTER THE 30 DAY WINDOW by emailing IDPH at
DPH.medicalcannabis@illinois.gov