Section 1-3 - Application for a Hemp Extract Registration Card (a) A person 18 years of age or older may apply for a registry card by submitting an application. The application packet must include: - (i) The applicant's name, date of birth, and address; and
- (ii) The name, address, and telephone number of the neurologist providing the written certification;
- (iii) A copy of the applicant's photographic identification showing proof of Wyoming residency;
- (iv) A written certification from a qualifying Wyoming licensed neurologist; and
- (v) A non-refundable $150 application fee.
(b) A parent or guardian 18 years of age or older may apply on behalf of a person under 18 years of age. The application packet must include: - (i) The qualifying patient's name, date of birth, and address;
- (ii) The parent or guardian's name and address;
- (iii) The name, address, and telephone number of the neurologist providing the written certification
- (iv) A copy of the parent or guardian's photographic identification showing proof of Wyoming residency;
- (v) An attestation that the parent/guardian is responsible for health care decisions for the qualifying patient;
- (vi) A written certification from a qualifying Wyoming licensed neurologist; and
- (vii) A non-refundable $150 application fee.
(c) All information submitted with the application will be maintained within the database created for the registry for a period of five (5) years.
Adopted, Eff. 10/16/2015.