Forms

To protect the health and safety of the public and our employees, DCP has limited on-site staffing at 450 Columbus Blvd. While mail and phone calls will be processed as quickly as possible, we recommend using our online services, or sending an email to the appropriate division/person instead. We apologize for any inconvenience.

Forms

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Patient/Caregiver

A patient or caregiver will report any changes in their applications within five (5) business days to the Medical Marijuana Program by using the Change of Patient Record Form.

Change of Dispensary Facility Form
Change of Record Form
Report of Lost, Stolen or Damaged Registration Certificate

Physician

Physician Decertification Form

Producers and Dispensary Facilities

Physical Alteration of a Dispensary Facility Form
Expansion of a Dispensary Facility Form
Physical Alteration of a Production Facility Form
Expansion of a Production Facility Form

MMP Advertising Guide for Dispensary Facilities and Producers
- Addendum (08/23/2016)

Connecticut State Department of Consumer Protection

Forms