Qualifying Patient/Primary Caregiver Renewal Application Checklist

Applicants needing to renew their ID cards must submit a renewal application through the online registry portal. Renewal applications must include any updated information and new/updated copies of the required documents. Patient applicants must obtain a new physician certification form, with the physician’s signature dated no more than 30 days prior to the renewal application submission date. A new patient authorization form is required for renewing caregivers.

Account Information

  • Username (email address) and password for the online registry portal

Individual Applicant Information

**This information will autofill from the current ID card, but should be verified and updated if the information has changed.**

  • Full legal name, date of birth, and social security number
  • E-mail address and phone number
  • Residence address and mailing address

Physician Certification Form

  • Qualifying patients must obtain a Physician Certification Form, signed no more than thirty days prior to the date the renewal application is submitted.
  • A Physician Certification Form must be completed, signed and submitted by either:
    • A Missouri-licensed Physician, active and in good standing; Or
    • A Nurse Practitioner who is licensed and in good standing as an advanced practice registered nurse, or successor designation, under Chapter 335 of the Revised Statutes of Missouri.
  • Certifying physicians and nurse practitioners will submit the form through the online registry portal. Qualifying Patients will then select the form within the patient application.

Required Documents

  • A clear, color photo of the applicant’s face taken within the prior three (3) months. This must not be a photo of a driver’s license or passport.
  • For non-emancipated qualifying patient applicants: A Parental/Legal Guardian Consent Form.
  • For Caregiver applicants: A completed Patient Authorization Form.
  • A legible copy of the applicant’s photo identification card issued by a state or federal government entity.

Additional Information and Requirements

  • Cultivation: If seeking authority to continue/begin to cultivate medical marijuana, details about the cultivation location, security and access will be required and must be updated if arrangements changed.
  • Attestations, signature, date of the application, and all applicable fees.