Get Change Replacement Or Surrender Request - Coloradogov

The Change Replacement Or Surrender Request form is essential for users who need to modify, replace, or surrender their medical marijuana card in Colorado. This guide provides step-by-step instructions to help you navigate the process effectively and ensure that all necessary information is accurately submitted.

Follow the steps to successfully complete the form online.

1. Click the ‘Get Form’ button to access the form and open it in your preferred editor.
2. Begin by completing the Patient Information section which includes entering your last name, first name, middle initial, date of birth, mailing address, telephone number, email, and county.
3. If you are requesting a replacement card, proceed to section 12. Enter the card number if known, and indicate whether your card was damaged, lost, or stolen, along with the date it occurred.
4. For a name change, complete section 13. Provide your new name and old name, and attach certified documentation such as a marriage certificate or court decree that verifies the name change.
5. To change your caregiver, fill out section 14. Specify whether you are adding or removing a caregiver, and provide their details. Remember to include the Caregiver Acknowledgment form.
6. If you need to change your homebound status, complete section 15. Indicate your current status and attach a new Physician Certification that reflects this change.
7. To surrender your card, fill out section 16. Indicate whether you are including your card with the request or if it is not available.
8. Before submitting, ensure you have signed the form in section 17a and included the date in section 17b.
9. Once the form is completed, save your changes, and you can either print it or share it as necessary. Submit the paperwork by mail or drop it off at the designated location.

Complete your Change Replacement Or Surrender Request online today!