Willamette Valley NORML - Medical Marijuana Law pages

HOW TO - a Guideline for Completing the Application for Registration in the Oregon Medical Marijuana Program.

Step (1) Get Forms from the OHD (among other sources) and begin the process of Applying. Get and fill out the Application for Registration in the Oregon Medical Marijuana Act Program. The OMMP sometimes has packets at the front desk (Oregon Health Division, 800 NE Oregon St., Portland, OR 97232) Or, call (971) 673-1234 and ask a representative of the Oregon Health Division for an OMMA application packet - or - write to OHD, P.O. Box 14450, Portland, OR 97293-0450 and they'll send you one. Or visit their website:   http://oregon.gov/DHS/ph/ommp/index.cfm   … and download forms from there.

NOTE: You must have a qualifying debilitating medical condition as listed on the Attending Physician's Statement. Debilitating Medical Condition: your physician Checks the appropriate boxes on the ATTENDING PHYSICIAN’S STATEMENT (see form )

1. Malignant neoplasm (Cancer)
2. Glaucoma
3. Positive status for Human Immunodeficiency Virus (HIV) or Acquired Immune Deficiency Syndrome (AIDS)
4. Agitation due to Alzheimer’s Disease
5. A medical condition or treatment for a medical condition that produces for a specific patient one or more of the following: (check all that apply)

a. Cachexia
b. Severe pain
c. Severe nausea
d. Seizures, including but not limited to seizures caused by epilepsy
e. Persistent muscle spasms, including but not limited to spasms caused by multiple sclerosis

Form Instruction NOTES: (a) Please complete Part A of the Application Form. Please provide a copy of a photo identification card as requested. If information on the front of the card is not current (for example, if your address has changed) please also photocopy the back of the id. (b) If a person over the age of 18 provides assistance to you, and you would like for that person to also receive a registration card, please complete Part B of the form, and provide a copy of photo i.d. of the primary caregiver. [Note: there is no additional fee for a primary caregiver registration card.] (c) Completion of Part C is optional. Please be sure to sign your name in Part D. (d) If you are a minor (under the age of 18), your parent or guardian must complete the Declaration of Person with Primary Custody of a Minor form. The form must also be notarized.

Step (2) Set an appointment & have your doctor sign the Oregon Health Dept. form - or - get a copy of your chart notations showing medical marijuana "may help alleviate symptoms". Your physician must be an MD or a DO licensed to practice in Oregon under ORS 677. He or she must provide signed, valid, written documentation stating that you are his/her patient, that you have been diagnosed with a debilitating medical condition covered by the Act, and that the medical use of marijuana may mitigate the symptoms or effects of your condition. This documentation may be in the form of a copy of your chart notes, a letter, or the attached Attending Physician's Statement form. [Note: chart notes or a letter must include all elements of the Attending Physician's Statement form.]

Step (3) Send in your application with registration fee. In order for your application to be complete, a fee of must be paid by check or money order. The fee is determined by the following:

* $100 for new applications;
* $100 for renewal applications;
* $20 for applicants who are enrolled in the Oregon Health Plan or who receive federal Supplementary Social Security Income.

To qualify for the $20 fee, applicants must submit documentation that verifies they are on the Oregon Health Plan or are receiving Supplemental Social Security income. Please make payable to: Oregon Health Division and send payment with your application forms and/or other materials. All information will be verified.

Step (4) Wait. All information will be verified. Upon receipt of a complete application, you will be issued a medical marijuana registration card by the Oregon Health Division. Please call (971) 673-1234 if you have any questions.

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