Effective 03/2018
Medical Marijuana Use Registry Identification Card Application
Instructions for Qualified Patients
In order to apply for a Medical Marijuana Use Registry Identification Card each patient must: be a Florida resident,
be diagnosed with a qualifying condition, and must have been added to the Medical Marijuana Use Registry (and
received a Medical Marijuana Use Registry Patient Identification Number) by a qualified physician, to receive
marijuana or a marijuana delivery device from an authorized Florida medical marijuana treatment center.
NEW PATIENT APPLICATIONS MUST INCLUDE ALL OF THE FOLLOWING
■
A completed application. By providing your email address, you consent to the Department contacting you
through the email address, including the provision of a temporary verification email.
■
A copy of your Florida driver license or Florida identification card, or other proof of residency listed below
■
A $75 check or money order (application fee) made out to Florida Department of Health.
■
A full-face, passport-type 2x2 inches in size, color photograph taken within the 90 days immediately
preceding application.
Minor applications must also include:
■
A designated caregiver and a Medical Marijuana Use Registry Identification Card
Caregiver Application
PROOF OF RESIDENCY
Patients must submit a proof of residency as follows:
1.
Adult residents must provide proof of residency as specified in section 381.986(5)(b)1., Florida Statutes.
2.
Adult seasonal residents must provide either proof of residency under section 381.986(5)(b)1. or provide a
copy of two documents as specified in section 381.986(5)(b)2., Florida Statutes.
3.
Minor patients must provide proof of residency as specified in section 381.986(5)(b)3., Florida Statutes. The
minor's parent or legal guardian must submit proof that they meet the residency requirement of section
381.986(5)(b)1., Florida Statutes.
The term “seasonal resident” means any person who temporarily resides in this state for a period of at least
31 consecutive days in each calendar year, maintains a temporary residence in this state, returns to the
state or jurisdiction of his or her residence at least one time during each calendar year, and is registered to
vote or pays income tax in another state or jurisdiction.
For all forms of residency, the name and address on the document(s) provided for proof of residency
must match the name and address provided in this application.