Section R. 333.103 - New registration application; qualifying patient and primary caregiverRule 3.
(1) A qualifying patient shall apply for a registry identification card in a manner prescribed by the department, which may include an online application. An applicant for a registry card shall submit the required fee and all of the following: (a) An original completed application that is signed by the qualifying patient and dated within 6 months of the date the application is received. The original completed application must include all of the following information: (i) The legal name, mailing address, and date of birth of the qualifying patient. The address for the qualifying patient must be a physical address located in this state. A qualifying patient who is homeless is not required to provide a physical address, but he or she shall provide a mailing address where the department can send correspondence regarding the patients registry status.(ii) The physicians name as it appears on his or her Michigan physicians license, mailing address, and telephone number of the qualifying patient's physician who provided the written certification.(iii) The legal name, mailing address, and date of birth of the patient's primary caregiver, if applicable. A qualifying patient may designate 1 primary caregiver to assist with his or her medical use of marihuana.(iv) A designation of whether the qualifying patient or the patient's primary caregiver, if applicable, will be allowed to possess marihuana plants for the qualifying patient's medical use.(v) An attestation by the primary caregiver named on the application that he or she agrees to serve as the patient's primary caregiver. The attestation must be signed by the primary caregiver and dated within 6 months of the date the application is received. The attestation must authorize the department to use the information provided on the application or as part of the attestation to secure the primary caregivers criminal conviction history and determine if he or she has been convicted of any of the offenses provided under section 3(k) of the act, MCL 333.26423.(vi) The department may require the attestation required under paragraph (v) of this subdivision to be submitted as part of the supporting documents and information required under subdivision (b) of this subrule.(b) The supporting documents and information required under section 6 of the act, MCL 333.26426, which must include all of the following: (i) Proof of the patients Michigan residency. For the purposes of this paragraph, an applicant shall be considered to have proved legal residency in this state if he or she provides the department with either of the following: (A) A copy of a valid, lawfully obtained Michigan driver license issued under the Michigan vehicle code, 1949 PA 300, MCL 257.1 to 257.923, or an official state personal identification card issued under 1972 PA 222, MCL 28.291 to 28.300. The department may waive this requirement if the department is able to verify the applicants Michigan driver license or personal identification card online through the department of state.(B) A copy of a valid Michigan voter registration. A patient who submits a copy of a valid Michigan voter registration shall also submit a copy of a government-issued document that includes the patients name and date of birth for verification purposes, as required in section 6(c) of the act, MCL 333.26426.(ii) A written certification, as defined in section 3(q) of the act, MCL 333.26423, signed by a licensed physician in the course of a bona fide physician- patient relationship as defined in section 3(a) of the act, MCL 333.26423, and dated within 6 months of the date the application is received. If the qualifying patient is under the age of 18, written certifications from 2 physicians are required. The physician shall include the legal name and date of birth of the qualifying patient, the physicians name as it appears on his or her physicians license, physicians license number, mailing address, and telephone number on the written certification.(iii) If the qualifying patient is under the age of 18, a declaration of person responsible form.(2) The department may allow an application, written certification, and any other required supporting documentation or information to be submitted online in a manner prescribed by the department. An online application process that meets the requirements of the act meets the requirements of this rule. For security purposes, the department may require a written certification and any other required supporting documentation or information to be submitted online.(3) The department may require a photograph as a design element for an official state registry identification card as provided in section 6(e)(5) of the act, MCL 333.26426, if the secretary of state forwards to the department the image of an applicant for an official state registry identification card.Mich. Admin. Code R. 333.103
2009 AACS; 2013 AACS; 2015 AACS; 2019 MR 20, Eff. 10/25/2019