Application Process

When a patient applies for a Medical Marijuana Identification Card, they must provide all of the following:

  • Completed application

  • Recommendation from their physician stating that the patient has a serious medical condition and that medical use of marijuana would be appropriate

  • Government-issued photo ID

  • Phone or utility bill that includes a current Alameda County address

  • $100 fee. Applicants on MediCal will be charged $50.

Once the application is completed, a photo of the applicant will be taken and the physician’s office will be contacted to verify the medical condition information provided. Once all information is verified, a state-issued Medical Marijuana Identification Card will be made available to the patient.

Medical Marijuana Program Application/Renewal Form – DHS 9042 (English)
https://www.cdph.ca.gov/CDPH%20Document%20Library/ControlledForms/cdph9042.pdf

Medical Marijuana Program Application/Renewal Form – DHS 9042 (Spanish)
https://www.cdph.ca.gov/CDPH%20Document%20Library/ControlledForms/cdph9042sp.pdf

Written Documentation of Patient’s Medical Records – DHS 9044 (English)
https://www.cdph.ca.gov/CDPH%20Document%20Library/ControlledForms/cdph9044.pdf

Written Documentation of Patient’s Medical Records – DHS 9044 (Spanish)
https://www.cdph.ca.gov/CDPH%20Document%20Library/ControlledForms/cdph9044sp.pdf

Denial Appeals Application (English)
https://www.cdph.ca.gov/CDPH%20Document%20Library/ControlledForms/cdph9043.pdf

Denial Appeals Application (Spanish Version)
https://www.cdph.ca.gov/CDPH%20Document%20Library/ControlledForms/cdph9043sp.pdf

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