How to Apply - Patient Information

 

dr and senior female

NEW! Click below to apply or to update an approved application

Patient/Caregiver
Application Registration What application
should I submit?

Click on the Patient/Caregiver Application Registration blue box located under the photograph to apply for your identification card. If a “Warning-Exiting Site” pop-up box appears, click “Yes” to proceed to the registry. Only applications submitted through the on-line registry will be accepted. For more information, review 19 CSR 100-1.040. Qualifying Patient/Primary Caregiver.

For information on how to enter and register patient and caregiver data into the on-line application, open the Online Registry Portal User Guide.

NEW: Application Tutorial Guides
Each video focuses on a specific topic in the application process to assist patients and caregivers with creating and managing their application, such as how to enter physician and condition information or to find and correct a rejected application.

Patient Forms

Steps to Licensure

steps to licensure

Get started with the Application Checklist and Patient Registry UserGuide.

Step 1: Forms

Notice: Electronic physician certification forms are available for verified physicians and nurse practitioners to submit for qualifying patients.

To begin, patients will need the Physician Certification Form completed by an MD, DO or NP in good standing in the state of Missouri.

Patients requiring more than the standard six (6) ounces per month will need one (1) physician certification form completed by an MD, DO or NP certifying them for an increased amount above the standard six (6) ounces.

Patients that are under the age of 18 will also need to complete and submit a Parent/Legal Guardian Consent Form with their application. This form must be completed and signed by the Parent/Legal Guardian that is listed in the minor patient’s application. Once the minor patient’s application has been approved, this Parent/Legal Guardian will be required to complete and submit a caregiver application.

Applying caregivers will need a Patient Authorization Form and the patients ID card number, which the patient will receive once their application is approved. This number will begin with PAT.

Step 2: Register

To complete an application, patients will need to register with the department’s secure electronic registration portal.

Step 3: Application

Once patients have registered, an application can be completed by logging into the Complia portal, clicking “+Create New Application” and “New Patient”.

Once caregivers have registered, an application can be completed by logging into the Complia portal, clicking “+Create New Application” and “New Caregiver”.

Renewal Application Information

  • Current ID card holders will be sent notices at intervals of 60, 45, 30 and 15-days prior to the ID card expiration date. These notices will be sent from the online registry portal to the email address used when registering for and logging into the portal. The window for submitting a patient or caregiver renewal is 60-days prior to, but no less than 30 days before, the expiration date. The system will not prohibit the submission of a renewal after the 30 day window, however the Department has 30 days from submission to process an application. Therefore we cannot guarantee a renewal that is received in this time frame will be processed prior to the ID Card expiration date. Please wait 24 hours following the receipt of a 60-day ID card renewal notification before submitting the renewal application in the online registry portal.