New location for submitting MMICP applications: Alameda County Public Health Department 1000 Broadway, Suite 310 Oakland, CA 94607 (510) 268-2977 Fax: (510) 268-7657 The Medical Marijuana Identification Card Program (MMICP) was established by the State of California following the passage of SB 420. MMICP requires counties to administer a voluntary card registration program that identifies medical marijuana patients. Patients can use the identification card as evidence that they have received a recommendation from their physician to use marijuana for medicinal purposes. The card can assist law enforcement officials in determining whether an individual using marijuana meets the requirements of the Compassionate Use Act, which states that with the recommendation of a physician, a seriously ill patient may obtain and use marijuana for personal medical purposes.

Program Eligibility:

In order to be eligible for Alameda County’s Medical Marijuana Identification Card Program, a person must: be a resident of Alameda County. be 18 years or older, or if under 18, provide documentation proving that the minor is emancipated or approval by the minor’s parent or legal guardian. have a serious medical condition, including AIDS, anorexia, arthritis, cachexia, cancer, chronic pain, glaucoma, migraine, persistent muscle spasm, seizures, or severe nausea. Eligible persons may have a chronic or persistent medical symptom that either substantially limits their ability to conduct one or more major life activities as defined by the Americans with Disabilities Act of 1990, or if not alleviated, a condition that may cause serious harm to the person’s safety, physical, or mental health. possess a recommendation from a physician indicating that medical marijuana is appropriate for their condition, or be a caregiver whose patient meets the above four conditions. 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 $103 fee. Applicants on MediCal will be charged $51.50. 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) www.cdph.ca.gov/pubsforms/forms/CtrldForms/cdph9042.pdf Medical Marijuana Program Application/Renewal Form – DHS 9042 (Spanish) www.cdph.ca.gov/pubsforms/forms/CtrldForms/cdph9042Spanish.pdf Written Documentation of Patient’s Medical Records – DHS 9044 (English) www.cdph.ca.gov/pubsforms/forms/CtrldForms/cdph9044.pdf Written Documentation of Patient’s Medical Records – DHS 9044 (Spanish) www.cdph.ca.gov/pubsforms/forms/CtrldForms/cdph9044(sp).pdf Population served: Residents of Alameda County who are at least 18 years or older who have a serious medical condition and are recommended by a physician. Key information: Informational Flyer Frequently Asked Questions

Web Links:

California Medical Marijuana Program – www.cdph.ca.gov/pubsforms/forms/Pages/MedicalMarijuanaProgram.aspx

Contact Information:

To apply for a Medical Marijuana Identification Card: Alameda County Public Health Department 1000 Broadway, Suite 310 Oakland, CA 94607 (510) 268-2977 Fax: (510) 268-7657