Arizona Administrative Code
Title 9 - HEALTH SERVICES
Chapter 17 - DEPARTMENT OF HEALTH SERVICES - MEDICAL MARIJUANA PROGRAM
Article 2 - QUALIFYING PATIENTS AND DESIGNATED CAREGIVERS
Section R9-17-203 - Amending a Qualifying Patient's or Designated Caregiver's Registry Identification Card

Universal Citation: AZ Admin Code R 9-17-203

Current through Register Vol. 30, No. 38, September 20, 2024

A. To add a designated caregiver or to request a change of a qualifying patient's designated caregiver, the qualifying patient shall submit to the Department, within 10 working days after the addition or the change, the following:

1. An application in a Department-provided format that includes:
a. The qualifying patient's name and the registry identification number on the qualifying patient's current registry identification card;

b. If applicable, the name of the qualifying patient's current designated caregiver and the date the designated caregiver last provided or will last provide assistance to the qualifying patient;

c. The name of the individual the qualifying patient is designating as caregiver; and

d. The signature of the qualifying patient and date the qualifying patient signed;

2. For the caregiver the qualifying patient is designating:
a. The designated caregiver's first name; middle initial, if applicable; last name; and suffix, if applicable;

b. The designated caregiver's date of birth;

c. The designated caregiver's Arizona residence address and Arizona mailing address;

d. The county where the designated caregiver resides;

e. The identifying number on the applicable card or document in subsection (A)(2)(h)(i) through (v);

f. An attestation in a Department-provided format signed and dated by the designated caregiver that the designated caregiver has not been convicted of an excluded felony offense as defined in A.R.S. § 36-2801;

g. A statement in a Department-provided format signed by the designated caregiver:
i. Agreeing to assist the qualifying patient with the medical use of marijuana; and

ii. Pledging not to divert marijuana to any individual who or entity that is not allowed to possess marijuana pursuant to A.R.S. Title 36, Chapter 28.1;

h. A copy the designated caregiver's:
i. Arizona driver's license issued on or after October 1, 1996;

ii. Arizona identification card issued on or after October 1, 1996;

iii. Arizona registry identification card;

iv. Photograph page in the designated caregiver's U.S. passport or a U.S. passport card; or

v. Arizona driver's license or identification card issued before October 1, 1996 and one of the following for the designated caregiver:
(1) Birth certificate verifying U.S. citizenship,

(2) U. S. Certificate of Naturalization, or

(3) U. S. Certificate of Citizenship;

i. A current photograph of the designated caregiver; and

j. For the Department's criminal records check authorized in A.R.S. § 36-2804.05:
i. The designated caregiver's fingerprints on a fingerprint card that includes:
(1) The designated caregiver's first name; middle initial, if applicable; and last name;

(2) The designated caregiver's signature;

(3) If different from the designated caregiver, the signature of the individual physically rolling the designated caregiver's fingerprints;

(4) The designated caregiver's address;

(5) If applicable, the designated caregiver's surname before marriage and any names previously used by the designated caregiver;

(6) The designated caregiver's date of birth;

(7) The designated caregiver's Social Security number;

(8) The designated caregiver's citizenship status;

(9) The designated caregiver's gender;

(10) The designated caregiver's race;

(11) The designated caregiver's height;

(12) The designated caregiver's weight;

(13) The designated caregiver's hair color;

(14) The designated caregiver's eye color; and

(15) The designated caregiver's place of birth; or

ii. If the designated caregiver's fingerprints and information required in subsection (A)(2)(j)(i) were submitted to the Department as part of an application for a designated caregiver registry identification card, dispensary agent registry identification card, or laboratory agent registry identification card within the previous six months, the registry identification number on the registry identification card issued to the designated caregiver as a result of the application; and

3. The applicable fee in R9-17-102 for applying for a designated caregiver registry identification card.

B. To amend a qualifying patient's address on the qualifying patient's registry identification card when the qualifying patient or the qualifying patient's designated caregiver is authorized to cultivate marijuana, the qualifying patient shall submit to the Department, within 10 working days after the change in address, the following:

1. The qualifying patient's name and the registry identification number on the qualifying patient's current registry identification card;

2. The qualifying patient's new address;

3. The county where the new address is located;

4. The name of the qualifying patient's designated caregiver, if applicable;

5. Whether the qualifying patient is requesting authorization for cultivating marijuana plants for the qualifying patient's medical use because the qualifying patient believes that the qualifying patient resides at least 25 miles from the nearest operating dispensary;

6. If the qualifying patient is requesting authorization for cultivating marijuana plants, whether the qualifying patient is designating the qualifying patient's designated caregiver to cultivate marijuana plants for the qualifying patient's medical use;

7. The effective date of the qualifying patient's new address; and

8. The applicable fee in R9-17-102 for applying to:
a. Amend a qualifying patient's registry identification card; and

b. If the qualifying patient is designating a designated caregiver for cultivation authorization, amend a designated caregiver's registry identification card.

C. To request authorization to cultivate marijuana based on a qualifying patient's current address or a new address, the qualifying patient shall submit to the Department, if applicable within 10 working days after the change in address, the following:

1. The qualifying patient's name and the registry identification number on the qualifying patient's current registry identification card;

2. If the qualifying patient's address is a new address, the qualifying patient's:
a. Current address,

b. New address,

c. The county where the new address is located, and

d. The effective date of the qualifying patient's new address;

3. The name of the qualifying patient's designated caregiver, if applicable;

4. Whether the qualifying patient is requesting authorization for cultivating marijuana plants for the qualifying patient's medical use because the qualifying patient believes that the qualifying patient resides at least 25 miles from the nearest operating dispensary;

5. If the qualifying patient is requesting authorization for cultivating marijuana plants, whether the qualifying patient is designating the qualifying patient's designated caregiver to cultivate marijuana plants for the qualifying patient's medical use; and

6. The applicable fee in R9-17-102 for applying to:
a. Amend a qualifying patient's registry identification card; and

b. If the qualifying patient is designating a designated caregiver for cultivation authorization, amend a designated caregiver's registry identification card.

Disclaimer: These regulations may not be the most recent version. Arizona may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.