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Program Activities
Office of Health Professionals Regulation
3 Capitol Hill
Room 104
Providence, RI 02908
401-222-2828
401-222-1272 Fax
Charles Alexandre, RN, MSN, Chief

 

 

Office of Health Professionals Regulation

Medical Marijuana Program (MMP)

 Applications for registration must be downloaded and printed. The completed form should be mailed to the address noted on the application. Forms will not be accepted via email or fax.

All forms are in pdf  pdf format.

Download; Then Print and Complete the Entire Application and required forms.

  • New Application - This application includes the following:
    Instructions
    Patient Form
    Physician Form
    (Minor Form) this form must be completed only if the patient is under the age of 18.

  • Change Form - This form must be completed if any information has changed since you have been registered.

NOTE:  Please provide your current contact information (phone/email) so that we may schedule you for your photo identification card upon approval of your application.

 

 

 

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