Five physicians sitting down

The Physician Certification Form must be completed and signed by a Missouri licensed physician who is active and in good standing to practice medicine or osteopathy pursuant to Missouri law. As part of the Physician Certification Form, it is recommended that physicians review the DHSS Guidance for Certification Appointments, found below, as physicians will be held to this standard for continued participation in the Missouri Medical Marijuana Regulatory Program.

The Department is working to finalize an integration in the registration portal to allow physicians to submit electronic Physician Certification Forms. While the integration is underway, the Department will continue to accept Physician Certification Forms as an uploaded document to the patient’s application, and PDF versions of these forms are located at the bottom of this page. Physician Certification Forms must not be issued more than 30 days before the date the patient will apply for a patient identification card or renewal of a patient identification card. Continued patient licensure requires an annual submission of a new Physician Certification Form.

Benefits to Electronic Physician Certification Forms

  • Security
    • The Department reviews and approves certifying physician account requests to verify identity of the physician and ensure they meet eligibility requirements of a certifying physician.
    • The physician has control of their account information and others they authorize to access their account, which reduces the potential for fraud related to submission of unauthorized Physician Certification Forms by third parties.
  • Streamlined Application Process
    • Electronic Physician Certification Forms submission creates efficiencies by reducing patient application requirements, patient errors, and department processing time, and allows physicians to make corrections to electronic Physician Certification Form errors using their account.
  • Direct Communication
    • Physician account registration supports direct communication between certifying physicians and the Department, strengthening our partnership in working to create a safe and secure program for Missouri medical marijuana patients.

DHSS Guidance for Certification Appointments

As part of the Physician Certification Form, physicians will be required to attest that certain statements are true. These attestations provide a framework for the certification process and are the primary way in which the Department has conveyed the standard of care it expects medical marijuana patients will receive. These expectations can be summarized as follows:

  • In the case of non-emancipated individuals under the age of eighteen, physicians must receive written consent of a custodial parent or legal guardian who will serve as a primary caregiver for the qualifying patient beforecertifying that patient.
  • The physician must meet with and examine the qualifying patient.
  • The physician must review the qualifying patient’s medical records or medical history and the qualifying patient’s current medications and allergies to medications.
  • The physician must have a conversation with the qualifying patient (or the qualifying patient’s custodial parent or legal guardian) about the patient’s current symptoms.
  • The physician must create a medical record for the qualifying patient regarding the meeting and maintain the qualifying patient’s medical record as required in 334.097, RSMo.
  • The physician must have a conversation with the qualifying patient (or the qualifying patient’s custodial parent or legal guardian) about the risks associated with medical marijuana, including any known contraindications applicable to the patient.
  • The physician must have a conversation with the qualifying patient (or the qualifying patient’s custodial parent or legal guardian) about the risks of medical marijuana use to fetuses and to breastfeeding infants, if applicable.

Any physician who falsely attests to these things may be subject to sanctions or penalties under applicable laws and regulations.

For more information regarding physicians and the Physician Certification Form, review rules 19 CSR 30-95.010 and 19 CSR 30-95.110.