| Name | Description | |
|---|---|---|
| Caregiver Application | This form is used to apply for an Arkansas Medical Marijuana Caregiver card. (Revised 2017-10-24) | Download |
| Information Change Request | This form is used by Qualified Patients and Caregivers who need to update information, request to add or remove a caregiver or cancel their registry ID card. (updated 12/10/2018) | Download |
| Patient Application | This form is used by an individual applying to be a qualifying patient. Revised (2017-09-18) | Download |
| Physician Written Certification | The Physician Written Certification form is to be filed out by a Physician to certify a qualifying medical condition. This form must be submitted online, or mailed to the Arkansas Department of Health, along with a completed and paid application within 30 days of physician's signature. (Revised 2019-05-30) | Download |