Get Medical Marijuana Program General Information Change Form

Filling out the Medical Marijuana Program General Information Change Form online is essential for ensuring your registration details are up to date. By following the streamlined steps provided here, you can efficiently complete this form to reflect any necessary changes in your information.

Follow the steps to successfully complete the form.

1. Press the ‘Get Form’ button to access the Medical Marijuana Program General Information Change Form and open it in your preferred online document editor.
2. Complete the section stating the change for your Medical Marijuana Registration Card. Indicate whether the change pertains to yourself as the registered patient or to your caregiver.
3. Provide your full name as it appears on your registration card, including your first name, middle name (if applicable), and last name.
4. Select the type of change you are reporting by marking the appropriate option. Options include change of residence address, change of mailing address, change of phone number, or change of email address.
5. If you are changing your residence address, input your original residence address and the new residence address. Note that additional forms are required if your original residence is a grow site location.
6. For changes to your mailing address, enter both the original mailing address and the new mailing address.
7. Update your phone number by providing the original phone number and the new phone number.
8. If your email address has changed, fill in both your original email address and the new email address.
9. Review your completed form for accuracy. Once you are confident all information is correct, provide your printed name, signature (or that of your legal guardian), and the date.
10. After finalizing the document, you may save changes, download the form, print it out for your records, or share it as needed.

Complete your Medical Marijuana Program General Information Change Form online today to ensure your information is up to date.