ASCEND Illinois
QUALIFYING AS A PATIENT
In order to get a medical cannabis qualifying patient card, some basic qualifications must be met.
- Must be 18 years or older
- Illinois state resident with proof of residency
- Diagnosis of a qualifying medical condition
- Healthcare Professional Written Certification
- Must not hold a school bus permit, CDL, or be an active duty law enforcement officer, correctional officer, correctional probation officer, or firefighter
FINAL CHECKLIST
Before submitting an application it’s good practice to double check that all required documents are accounted for. This will ensure timely processing of the application and avoid easy mistakes.
- Healthcare Professional Written Certification form
- Complete & signed Patient Application
- Application fee
- Photograph (passport compliant)
- Proof of residency
- Proof of age & identity
- DD214 (if veteran)
- Designated caregiver application (if applicable) *
* For parents attempting to access medical cannabis for their children, an additional reviewing physician’s certification is required, with the parent or legal guardian serving as primary caregiver for the patient.
APPLICATION FORMS & DELIVERY
Patients must mail their application, fees and required documents below.
- Qualifying Patient Application
- Healthcare Professional Written Certification Form
- Designated Caregiver Application Form
- Terminal Illness Application
- Terminal Illness Application for Veterans receiving medical services healthcare at a V.A. Facility
- Application for Qualifying Patients under 18 years of age and their Designated Caregiver
1. HEALTHCARE PROFESSIONAL WRITTEN CERTIFICATION
Meet with your healthcare professional to discuss the use of medical cannabis for the treatment of your condition. This is an important first step in the application process. Your healthcare professional must complete and mail this form to the IL. Department of Public Health (IDPH). Your appointment must be within 90 days of submitting your application to the department.
Click here for tips on talking to your doctor.
2. COMPLETE & SIGN PATIENT APPLICATION FORM
Fill in all parts of the application, choose a medical cannabis dispensing organization and sign the last page. You may also fill out the optional demographic information. If you do not want to designate a caregiver, don’t fill out that section of the application.
Under Illinois’ Compassionate Care Act, Patients must select a dispensary they intend to purchase products form. To select IS&P as your Dispensary, complete the form with IS&P location information as follows:
Illinois Supply & Provisions 1014 Eastport Plaza Drive Collinsville, IL 62234 District 11 Registry #11-002
Illinois Supply & Provisions 628 East Adams Springfield, IL 62701 District 9 Registry #09-002
3. APPLICATION FEE
Qualifying patients and caregivers may apply for a one, two, or three-year registry identification card. Persons who are receiving Social Security Disability Income (SSDI) or Supplimented Disability Income (SSI) and veterans may be eligible for a reduced application fee. (Page 2 of 4 on the Qualifying Patient Application form.) Application Fees are non-refundable. (Check or Money Order to Illinois Department of Public Health)
4. PHOTOGRAPH REQUIREMENTS
- Taken in the last 30 days
- Taken against a plain, white or off-white background or backdrop
- In natural color (Do not use a filter)
- Full-face view directly facing the camera with a neutral facial expression and both eyes open
- At least 2 inches by 2 inches in size
- It’s recommended you use a passport photo vendor to ensure the photograph meets these requirements.
5. PROOF OF RESIDENCY
You will need two items that prove you live in Illinois. The address on each of the documents must match the address on your application. Bank statements, utility bills, state ID, diver’s license and voter ID cards are all acceptable. Check the application for a full list.
6. PROOF OF AGE & IDENTITY
Submit a clear color copy of a valid, unexpired Illinois Driver’s license, Illinois State ID, or the photograph page of a US passport.
7. VETERANS ONLY
Veterans receiving health care at a VA facility do not need to provide a Healthcare Professional Written Certification, but must instead provide medical records from the VA facility for the last 12 months. Once your receive your official medical records, your must submit the medical records wuth your application.
Send in a copy of your DD214 and a check for the applicable application fee (page 2 of 4 on the Qualifying Patient Application form.)
8. CAREGIVER ONLY
Complete the entire caregiver application and send it with the $25 caregiver fee for a one year card or $75 for a three year card and all the supporting documents (photo, proof of residency, proof of age and identity, fingerprint consent form, caregiver’s signature). The caregiver application should be sent with your patient application. Click here to download the Caregiver Application form.
NEED HELP OF HAVE QUESTIONS?
If you have a question, check with the Division of Medical Cannabis before sending your application. Call the Illinois Department of Public Health at 855-636-3688 or send an email to [email protected].