GET A CARD – ARIZONA

The Arizona Department of Health Services has put together some very helpful information to guide potential patients through the application process.  Below you can find links to all of these resources.  

For a list of qualifying conditions click here.

  • Cancer
  • Glaucoma
  • Human Immunodeficiency Virus (HIV)
  • Acquired Immune Deficiency Syndrome (AIDS)
  • Hepatitis C
  • Amyotrophic Lateral Sclerosis (ALS)
  • Crohn’s Disease
  • Agitation of Alzheimer’s disease
  • A chronic or debilitating disease or medical condition or the treatment for a chronic or debilitating disease or medical condition that causes:
    • Cachexia or wasting syndrome;
    • Severe and chronic pain;
    • Severe nausea;
    • Seizures, including those characteristic of epilepsy;
    • Severe or persistent muscle spasms, including those characteristic of multiple sclerosis

ADULT PATIENT INFO

Take a look at the checklist provided by ADHS and make sure you have everything completed before sending in your application or applying online.  Applicants are required to print the Physician Certification Form and have it completed by their doctor.

Adult Patient Checklist

Adult Patient Info

Online Application

Physician Certification Form

Attestation Form

MINOR PATIENT INFO

Patients under the age of 18 require a parent or legal guardian to apply with them.  Take a look at the under 18 qualified patient checklist and make sure you have completed all steps before sending your application or applying online.

Minor Patient Checklist

Minor Patient Info

Minor Patient Online Application

Physician Certification Form

Parent/Guardian Attestation Form

DESIGNATED CAREGIVER  INFO

Arizona MMJ patients have the option to assign a designated caregiver who can help them get the care they need.  Potential caregivers are required to provide fingerprints along with their application.  Take a look at the Designated Caregiver Checklist before sending in your application or applying online.

Caregiver Checklist

Caregiver Info/Instructions

Caregiver Application

Fingerprint Form

Fingerprint Instructions

Caregiver Attestation Form