Forms

Patient - Change of dispensary facility request.

Submissions will be completed electronically, by logging into the patient approved registration.

Select the new dispensary facility and click the “save” button. The change will take effect immediately after the “save” button is clicked.

The maximum number of times a patient can change dispensary facility is 4 times a year. Changes to a dispensary facility can only be made once every 24 hours.

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.

Patient/Caregiver Registration Replacement

A patient and/or caregiver who needs a replacement registration, can do so by accessing their current registration profile from Biznet.

Your application status needs to be “Approved”. By clicking the “Print MMP Certificate” button, the system will allow you to print the most recent approved valid registration certificate at no additional cost.

However, if your profile is missing the “Print MMP Certificate” button please contact us at dcp.mmp@ct.gov with the subject line: missing Print MMP Certificate button. We will then enable the “Print Certificate” button in your current application.

If the “Report of Lost, Stolen or Damaged Registration Certificate” form has to be manually processed for any reason, patients/caregivers must submit the form and pay the $35 fee.

• Report of Lost, Stolen or Damaged Registration Certificate

Physician

Producers and Dispensary Facilities  

• Physical Alteration of a Dispensary Facility Form
  
• Expansion of a Dispensary Facility Form
• Change of Dispensary Facility Name Form
• Change of Dispensary Facility Location Form
• Change Dispensary Facility Manager Form
  
  
• Physical Alteration of a Production Facility Form 
• Expansion of a Production Facility Form
• Change of Production Facility Name Form
• Change of Production Facility Location Form

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