First, fill out the and cover sheet. Please be sure to include your doctor’s name and phone number and send it in. The Michigan Medical Marijuana Certification Center will contact your doctor to obtain your medical records. Once we’ve received your medical documents, we’ll call you to set up an appointment.
Patients must suffer from a debilitating medical condition, defined as:
• cancer, glaucoma or positive status for human immunodeficiency virus (HIV), acquired immune deficiency syndrome (AIDS), hepatitis C, amyotrophic lateral sclerosis, Crohn’s disease, agitation of Alzheimer’s disease or nail patella.
• a chronic or debilitating disease or medical condition or its treatment that produces one of more of the following:
o cachexia or wasting syndrome;
o severe or chronic pain;
o severe nausea;
o seizures, including but not limited to those caused by epilepsy; or
o severe or persistent muscle spasms, including but not limited to, those which are characteristic of multiple sclerosis; or
• any other medical condition or treatment for a medical condition that is defined as chronic and debilitating.
Why do I need to have a physician sign and date an “Attending Physician’s Statement” form? Why can’t I just provide my medical records?
According to the Michigan Medical Marijuana Act (MMMA), a physician must state in writing that the patient has a qualifying debilitating medical condition and that medical marijuana may mitigate the symptoms or effects of that condition. The Michigan Medical Marihuana Program (MMMP) contacts each physician during the application process to verify that the patient is under the physician’s care. A signed and dated “Attending Physician’s Statement,” must be current within 3 months of the date of a person’s new or renewal application.
Our physicians require that each patient have current medical records within past 3 years that document the existence of one of the conditions for which medical marijuana is authorized under Michigan state law. You must either obtain your medical records yourself (which may involve a fee) and mail or fax them in to us, or you may authorize that your medical records be faxed or mailed to our office. MMMCC requires the records to be current within the past three years and relate to your qualifying condition. Documentation is required for at least two (2) of your most recent visits pertaining to your qualifying condition for your medical marijuana application.
Our staff can obtain your medical records with a or you can call your physician or the hospital where you received treatment and tell them you need copies of your medical records. They will tell you the process of obtaining your medical records and usually have you sign an authorization form to release the records.
You may send your records to one of the following:
“Qualifying patients” must register with the Michigan Medical Marihuana Registry Program ∙ PO Box 30083 ∙ Lansing, MI 48909, the patient must submit the following information via the Registry Form:
• Mail Medical Records to our physical address at:
29877 Telegraph Road, Building 2 Suite 303
Southfield, MI 48034
• Fax Medical Records to 248.932.6362.
Faxes must be 25 pages or less
It is your responsibility to make sure your medical records have arrived to our office in full and ready for review if you wish to be considered for a medical marijuana appointment.
No. MMMCC can evaluate anyone who feels that they can benefit from medical marijuana.
A qualified patient with the required medical marijuana documents will receive a signed State Certification Form that allows them to apply for the Medical Marijuana Identification Card from the State of Michigan with the approval of your treating physician(s).
Certifications are valid for two years after your medical marijuana registration is approved. We recommend that you to make an appointment before the expiration date so that you can be re-evaluated and obtain a renewal of your physician certification.
The MMMP has 15 days to review your medical marijuana application to make sure it is complete. If approved, your medical marijuana registration identification card will be issued within 5 days.
“Qualifying patients” must register with the Michigan Medical Marihuana Registry Program, P.O. Box 30083, Lansing, MI 48909.
To register, the patient must submit the following information via the Registry Form:
An application or renewal fee;
∙ A completed Application Form
∙ A completed Physician Certification
∙ A completed Caregiver Attestation (if applicable)
Medical marijuana registration forms are available at http://www.michigan.gov/mmp
Will my insurance company cover the certification process, consultation or medical marijuana application?
No. Insurance companies do not cover the cost of certification process, consultation or application for medical marijuana at the current time.
Your total cost will be $175 to $250 including physician visit and application.
• The State of Michigan charges $100 to file an application ($25 if enrolled in Medicaid Health Plan or receiving SSI).
• Michigan Medical Marijuana Certification Center charges a $150 fee at the time of the physician visit.