Name of the Organization : Health & Human Services Agency San Diego
Type of Facility : Apply for Medical Marijuana Identification Card
State : California
Country : United States of America
Website : http://www.sandiegocounty.gov/content/sdc/hhsa/programs/phs/mmic.html
Application Form : https://www.statusin.org/uploads/25899-mmic.pdf
MMIC How to Apply :
** For more information phone (619) 692-5723 or send us an email.
Related : Health & Human Services Agency San Diego Electronic Benefit Transfer Card EBT : www.statusin.org/25895.html
Eligibility :
** San Diego County residents with a serious medical condition.
Qualifying conditions are :
** AIDS
** Anorexia
** Arthritis
** Cachexia
** Cancer
** Chronic Pain
** Glaucoma
** Migraine
** Seizures
** Severe nausea
** Persistent muscle spasms
** Any other chronic or persistent medical condition that either:
** limits their ability to conduct one or more major life activity as defined by the American Disability Act of 1990; or may cause harm if not alleviated.
Process :
** Application forms can be obtained by mail, in person or online in English and Spanish.
** Completed applications are accepted by appointment only.
** To schedule an appointment please call (619) 692-5723.
At the time of your application submission, you must present the following :
** A completed Medical Marijuana Identification Card (MMIC) Application/Renewal Form.
** A valid government-issued photo ID, such as current and valid motor vehicle driver’s license or identification card issued by the California Department of Motor Vehicle (DMV).
** This includes United States Passport or a Veteran’s Administration Card.
** Proof of residency in San Diego County such as a current and valid California Motor Vehicle registration, a current rent/mortgage receipt or utility bill.
** This proof must have patient’s name bearing current physical address within the county.
** Please ensure that the documents are clear and legible with no erasures, whiteouts or any alterations.
** Written documentation or the CDPH 9044 form from your physician recommending the use of medical marijuana as appropriate for one or more serious medical conditions.
** This documentation must include an original signature and be on the physician’s business letterhead or on the “Written Documentation of Patient’s Medical Records” form (CDPH 9044).
** The medical condition is NOT to be listed.
** Your physician’s name, contact information and California medical license number.
** Non-refundable application fee of $166 (or $83 for Medi-Cal beneficiaries.)
** Acceptable forms of payment are cash, cashier’s checks, money orders–no personal checks are accepted.
** Credit and debit cards are accepted through VitalChek with a $2.50 convenience fee.
** Current Benefit Identification Card (BIC) and/or Medi-Cal card if you are a Medi-Cal beneficiary.
Minors:
** Proof of emancipation; non-emancipated minors must be accompanied by a parent or legal guardian.
Primary Caregivers, if any, must provide the following documentation with their application :
** A valid government-issued photo ID, such as current and valid motor vehicle driver’s license or identification card issued by the California Department of Motor Vehicles (DMV).
** Proof of residency in California. Some restrictions apply, please ask for details.
** Non-refundable application fee of $166 (or $83 for caregivers of Medi-Cal beneficiaries)
** Caregivers must accompany the patient when submitting the application.
Denials :
** All appeals are handled by the State.
** Should your application be denied and you wish to appeal, please complete the Denial Appeals Application Form, and mail this form along with a copy of your denied application to the State at
California Department of Public Health
Office of County Health Services
Appeals Desk, Medical Marijuana Program
MS 5203
P.O. Box 997377 Sacramento, CA 95899-7377
** The appeals paperwork must be completed within 30 calendar days from the date you were notified of your application denial.
** For further information on the appeals process, please contact the State’s Medical Marijuana Program at (916)-552-8600.