This form is used to apply for an Arkansas Medical Marijuana Caregiver card. (Revised 01/2023)

 

This form is used by Qualified Patients and Caregivers who need to update information, request to add or remove a caregiver or cancel their registry ID card. (Revised 02-11-2020)

 

This form is used by an individual applying to be a qualifying patient. This application includes the Physician Written Certification form. This form is to be filled out by a Physician to certify a qualifying medical condition. This form must be submitted online, or mailed to the Arkansas Department of Health, along with a completed and paid application within 30 days of physician's signature. (Revised 03/2023)