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. Physician Certifications must not be issued more than thirty (30) days before the date the patient will apply for a patient identification card or renewal of a patient identification card. At this time, the department is only accepting the Physician Certification as an uploaded document to the patient’s application which can be submitted as early as June 28, 2019.

For more information regarding physicians and the Physician Certification Form, review 19 CSR 30-95.010 and 19 CSR 30-95.110 which can be found by using the topics bar at the right-side of the page to navigate to the Rules webpage.