North Dakota Medical Marijuana

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A Terminal Illness

Acquired Immune Deficiency Syndrome

Agitation of Alzheimer's Disease or related Dementia

Amyotrophic Lateral Sclerosis

Anorexia Nervosa

Anxiety Disorder

Autism Spectrum Disorder

Brain Injury

Bulimia Nervosa

Cancer

Crohn's Disease

Decompensated Cirrhosis caused by Hepatitis C

Ehlers-Danlos Syndrome

Endometriosis

Epilepsy

Fibromyalgia

Glaucoma

Interstitial Cystitis

Migraine

Neuropathy

Positive Status for Human Immunodeficiency Virus

Post-traumatic Stress Disorder

Rheumatoid Arthritis

Spinal Stenosis or chronic back pain, including neuropathy or damage to the nervous tissue of spinal cord with objective neurological indication of intractable spasticity

Tourette Syndrome

A chronic or debilitating disease or medical condition or treatment for such disease or medical condition that produces one or more of the following:

•Cachexia or wasting syndrome

•Severe debilitating pain that has not responded to previously prescribed medication or surgical measures for more than three months or for which other treatment options produced serious side effects

•Intractable nausea

•Seizures

•Severe and persistent muscle spasms, including those characteristic of multiple sclerosis.

Patient Application Instructions:

Non-Minor (19 years and older)

Welcome to the North Dakota Medical Marijuana Program!

Applications will be completed and submitted online via the BioTrackTHC system. General information data fields that must be completed include:

•Applicant name

•Date of birth

✓Please Note: applicant name and date of birth should match what is on applicant’s ND state issued driver’s license or ND state issued non-driver identification card.

•Address

•Phone number

•Email address

✓Please Note: all information must be current to avoid any delay in the application process.

In addition, applicants will be required to submit the following:

•An uploaded photo

oThis is the photo that will go on the ID card if the application is approved.

oApplicant must be facing the camera directly with their full face in view. Do not tilt the photo.

oDo not use a filter.

oEyes must be open.

oThe background of the photo should be plain (plain white or off-white background is best).

oPhoto should be in color and not black and white or sepia.

oAvoid wearing dark, tinted glasses, hats or head coverings when taking the photo.

oThe system will accept various image formats, including jpeg and png.

•An uploaded copy of the front of the applicant’s ND state issued driver’s license or ND state issued non-driver identification card.

✓PleaseNote: copies of the driver’s license or non-driver identification card can be submitted in various formats including jpeg, png, or pdf. If uploaded images are of poor quality, it could result in a delay in the application process.

•Name of health care provider who will be completing the written certification

•Email address of health care provider who will be completing the written certification

✓Please Note: health care provider information must be correct. Misspelling of a provider name or an incorrect email address could result in a delay in the application process.

Applicants will be asked three questions:

•Is the patient able to make their own medical decisions?

oIf answered “no” additional information will need to be provided.

•Does the patient intend to have a designated caregiver?

oIf answered “yes” additional information will need to be provided.

✓Please Note: a designated caregiver must submit a separate application specific to designated caregivers in order to receive a registry ID card and be able to purchase, assist in the use of, or possess products under the Medical Marijuana Program on behalf of a registered patient.

✓Please Note: a designated caregiver must provide the patient barcode number and patient name as part of their application.

•Is the patient a veteran?

oIf answered “yes” an additional question regarding health care services/treatment will need to be answered.

Medical Release of Information:

•As part of the application, an applicant must sign a medical release of information related to the applicant’s debilitating medical condition. This is required by state law for the program to certify the applicant as a Medical Marijuana Program participant.

✓Please Note: to prevent delays in the application process, it may be beneficial for an applicant to also complete a release of information from their health care facility that will allow the Division of Medical Marijuana access to medical information related to a patient’s qualifying medical condition. An applicant should consult with their healthcare facility regarding this.

Written Certification (to be completed by the patient’s health care provider):

•Once an applicant has submitted their health care provider’s full name and email address, the provider will be notified to complete the written certification for the applicant/patient. The applicant does not provide the written certification, as it will come directly from the health care provider.

✓Please Note: to avoid delays in processing the application, please ensure the health care provider’s name is spelled correctly and their work email address is entered correctly.

Application Fee:

•At this time, the $50 non-refundable application fee must be paid by check or cashier’s check and mailed in. Checks should be made payable to the NDDoH Medical Marijuana Program.

•Write the applicant’s ten-digit alphanumeric identification number (barcode number) in the “memo/for” line of the check (lower, left corner).

•Mail payment to:

NDDoH, Division of Medical Marijuana

600 East Blvd Ave, Dept 301

Bismarck, ND 58505

State Law and Administrative Rules:

•Applicants should be familiar with state law and administrative rules that govern the Medical Marijuana Program (NDCC Chapter 19-24.1 and NDAC Chapter 33-44-01), which can be found on the Division of Medical Marijuana website www.ndhealth.gov/MM

Submitting Inaccurate, Incorrect, or False Information:

•Inaccurate or incorrect information could result in a delay in processing of an application.

•An applicant who knowingly submits false records or documentation required by the Division of Medical Marijuana to receive a registry identification card will be permanently disqualified from participating in the Medical Marijuana Program.

•A material misstatement by an applicant may be result in the registry identification card being suspended or revoked.

Your BioTrackTHCAccount:

Applicants can log into their BioTrackTHC account at any time to:

•View and edit certain information on their account

•View and edit an application that was started but not submitted

✓Please Note: once an application is submitted, the applicant will not be able to edit their application. If a change needs to be made, please contact the Division of Medical Marijuana.

•View their submitted application and track where it is at in the review and approval process.

•Check their 30-day maximum purchase limit balance.

For more information or if you need an accommodation, please call 701.328.1311.

Following the submission of all necessary application documentation and receipt of a written certification from the patient’s health care provider, please allow 2-4 weeks for processing. You can track your application status by signing into your account. Delays in processing may result from incomplete information, payment not being received, or unclear photos or other uploaded documents.

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