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Medical Applications, Forms and Submission Information

**IMPORTANT PROGRAM UPDATE**

Effective March 1, 2022, caregiver applicants are required to obtain a fingerprint based criminal history record check. Section 3.3.3 of the rules allows the Board to temporarily register caregiver pending the completion of a criminal history check, provided the applicant is a spouse, domestic partner, child, legal guardian, parent, sibling, grandparent, or grandchild of the Patient.

To meet this requirement, the caregiver must make and appointment with one of the 15 identification centers in Vermont. A list of those identification centers along with guidance on the fingerprinting process can be found here 2019 Identification Centers.pdf (vermont.gov)

The Medical Cannabis Program staff will provide you with an authorization form to be taken to the fingerprint identification center. Please email ccb.med@vermont,gov to request your form. There is a processing fee of $25, to be paid at the identification center upon service.

Once your fingerprints are recorded with the identification center, those records are sent to the Vermont Crime Information Center (VCIC) directly for processing. Medical program staff will receive notification from VCIC when the results are ready.

Submit Your Application Electronically

What am I able to do electronically?

  • Submit your initial or renewal application
  • Pay electronically (you may also mail a check or money order after your electronic submission)
  • Request to be a qualified healthcare provider under the medical cannabis program

For patients and caregivers with existing credentials

Access your existing user account here

Forgot your credentials? No problem - email us!

For first-time patients, caregivers, and healthcare providers

Submit an initial patient application Submit an initial caregiver application Healthcare professional provider account

You do not need to submit a printed application in addition to applying online.

Print and Mail Applications

Renewing patients and caregivers who do not have an online portal account should email the medical program to request an account. A username and temporary password will be sent to you.

What am I able to do by mail?

  • Submit your initial or renewal application
  • Pay by mail via check or money order
  • Request to be a qualified healthcare provider under the medical cannabis program

For patients and caregivers submitting via printed application

Full registration packet (includes all individual forms for patients, caregivers, and health care professionals)

Patient application Caregiver application
Change request form (to request a new ID card or to change to personal information) Denial of medical card appeal form

For healthcare professionals:

Verification form (included in full registration packet above) Mental health care provider form

Printed applications should be mailed to:

Cannabis Control Board

Attn: Medical Program

89 Main Street

Montpelier, VT 05620