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medical marijuana identification card program

 MMICP - Useful Links 

611459765Forms

CDPH 9042 (PDF) - ​Medical Marijuana Program Application/Renewal

CDPH 9042 SP (PDF) - Medical Marijuana Program Application/Renewal (Spanish Version)

CDPH 9043 (PDF) - Denial Appeals Application

CDPH 9043 SP (PDF) - Denial Appeals Application (Spanish Version)

CDPH 9044 (PDF) - Written Documentation of Patient's Medical Records

CDPH 9044 SP (PDF) - Written Documentation of Patient's Medical Records (Spanish Version)

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Appeals Process

If your application for a Medical Marijuana Identification Card is denied, you may file an appeal at no cost. 

To file an appeal, you must complete and directly submit an Appeals Form (PDF)  to the California Department of Public Health (CDPH) within 30 calendar days of the date you recieved a denial notice from your county program.

For a copy of the Appeals Form (PDF), you may contact your county program or download the electronic copy (este formulario también está disponible en Español (PDF)) yourself.

​​To submit an appeal, mail a completed Appeals Form (PDF) with a copy of your denial letter to:

California Department of Public Health

Medical Marijuana Identification Card Program

Attention:  Appeals

P.O. Box 997410, MS 5202

Sacramento, CA  95899-7410

Please sign and date your appeals form. By signing your appeals form, you are giving consent for your county program to release information contained in your application file to CDPH. This information will be used to evaluate your appeal.  A decision notice regarding your appeal will be sent to you and your county's program.

All appeal decisions by CDPH's Medical Marijuana Identification Card Program are final.

Your application may be denied if you fail to provide all required information, your county program determined the application information was false, or you did not meet the requirements for being a qualified patient or primary caregiver.

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