Forms for Patients
Maine state law requires physician verification of conditions that legally qualify a patient for medical marijuana certification.

Thus, the more information you can provide us to verify your qualifications for medical marijuana, the more likely we will be able to provide you with state certification. To this end, we require all of our new patients to complete the "New patient form" below, a form that allows you to tell us how you qualify. In addition, new patients who can provide past medical records or a statement from their provider are much more likely to be rapidly certified than those who cannot. 

IMPORTANT: We do not review x-rays or records older than 5 years, laboratory results (except for hepatitis C or HIV confirmation). In other words, confirmation of your qualifying condition requires a fairly recent visit to your doctor. Records sent to us should be limited to 10 pages or less and be directly relevant to the condition you believe qualifies you for medical marijuana certification.

Past records can be obtained by signing the "Patient records form" below and delivering it to your provider, clinic, or hospital records department. 

If you are applying under the chronic pain provision, you can also speed the certification process by having any of your current or past providers complete the "Patient pain history form" below.

The tamper-proof certificate you received is good for one year and must be kept with a state-issued identification to legally obtain, carry, and use medical marijuana in Maine. For patients who would like a more portable document, Maine will provide certified patients with a wallet card that may be carried instead of the certificate. Prior to 2011, this wallet card was available from the state for a fee. In 2011, the legislature updated the law (1) making the card optional if the original physician certificate was carried instead and (2) removed the fee for patients who still wished to carry a card instead of the certificate. 

Thus, the medical marijuana card is available for currently certified patients who complete and send in the following form.

Further information on patients' rights and limits are contained in the handout below.

The publication below contains the entire Maine statute enacted in 2010. Note that amendments applied since the original law went into effect are not contained in this document.

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