Forms and Applications

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Medical Marijuana Identification Card Program - Forms

Our Location: 1221 Fulton Street, First Floor
P O Box 11867, Fresno CA 93775-1867
Phone: (559) 600-3434 Fax: (559) 600-7601
By Appointment Only: Bi-Weekly on Fridays 8:00am - 11:30pm and 1:00pm - 3:30pm

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 MMICP Forms

  • Medical Marijuana Program Application/Renewal form (cdph9042)
  • Written Documentation of Patient's Medical Record (cdph9044)
    Denial Appeals Application (cdph9043)