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Medical Applications, Forms and Submission Information

We Are Processing Applications Received On

April 1, 2022

 

 

 

 

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 healthcare professionals)

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

For healthcare professionals:

Verification form (included in full registration packet above) Mental healthcare provider form (required for treating PTSD patients)

Printed applications should be mailed to:

Cannabis Control Board

Attn: Medical Program

89 Main Street

Montpelier, VT 05620