Name of the Organization : Arizona Department of Health
Type of Facility : Medical Marijuana Online Registry System
State : Arizona
Country : United States of America
Website : https://medicalmarijuana.azdhs.gov/
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Medical Marijuana Online Registry System
The ADHS Division of Licensing Services licenses and monitors health and child care facilities and providers throughout Arizona.
Go to the official website,click on the online provider services in home page.
Click on the Medical Marijuana cards option in left panel of the home page.
Click on the New application option then select the Qualifying patient application option.
Before beginning the application process, be sure you have the following items in digital format ready for upload:
** Electronic copy of photo identification;
** Current digital photograph;
** Electronic copy of completed and signed physician certification form;
** Electronic copy of completed and signed qualifying patient attestation;
** Visa or Mastercard for payment; and
** Supplemental Nutrition Assistance Program(SNAP) documentation, if applicable
Read all the instruction tick the i agree check box.
Patient Application :
1. Tick the check box Arizona Medical Marijuana Act
Patient Information :
1. Enter First Name
2. Enter Middle Name
3. Enter Last Name
4. Enter Suffix
5. Enter Date of Birth
6. Select Gender
7. Enter ID Type
8. Enter ID Number
9. Enter Issuing State
10. Enter Issued Date
Residence Address :
1. Enter Address
2. Enter Zip
3. Enter City
4. Enter County
5. Enter State
6. Enter Phone Number
7. Enter Email Address
8. Alternate E-Mail Address
Mailing Address :
Check if mailing address is the same as residential.Click on the check box
Supplemental Nutrition Assistance Program Eligibility :
Tick the check box If you are eligible for SNAP assistance and proper documentation is provided, your application fee will be reduced from $150 to $75
Tick the check box Approval to cultivate cannot be approved without a residential address
Click on Save button
Conformation message will be displayed click on yes button.
Medical Marijuana Application Status
1. Please Enter Application ID
2. Click on submit button.