Cultivating a New Tomorrow

Terminal Illness

You Don’t have to go Through This Alone, We Are Here to Help.

Handling such news in your life is enough to deal with and navigating through websites can be quite time consuming. We have gathered all the information for you in an efficient step by step process.

How to Obtain Your Medical Cannabis Card

The Illinois Department of Public Health issues the Medical Cannabis Patient Registry Identification Card. Here’s a summary of what you’ll need to apply:

Qualifying patients (Adults and Persons under age 18)

Veterans receiving care at a U.S. Department of Veterans Affairs (VA) Facility

The Application Process

Your first step toward becoming a patient starts with filling out a form. To help keep track of the process, we have provided the following checklist. There are many steps involved, and it’s easy to get confused. Therefore, we are here to help guide you through the process, and we suggest you print hard copies for easy reference. Applications cannot be submitted on-line.

Persons diagnosed with a terminal illness with a life expectancy of six (6) months or less may apply for a medical cannabis registry identification card valid for six months. There is no application fee.

Application Checklist

  1. Once your doctor has given a diagnosis of Terminal Illness
    • S/he must complete a Physician Written Certification Form on page 3
    • Schedule your appointment within 90 days of submitting your personal application
    • Veterans: You must submit a copy of your DD-214 showing dates of service and character of service (type of discharge)
    • Provide a copy of your medical records from the VA facility for the last 12 months
    • Complete the Attestation of Terminal Illness (page 6 of the application package). This form must be notarized
  2. Fill out your personal Patient Application Form completely and accurately
    • On the form, you can choose a cannabis dispensary, but it’s not necessary
    • If you do not want to assign a caregiver, leave that section blank
    • Remember to sign the last page of your patient application
    • Do not send in your application without all of the above and following support documentation
  3. If you choose to assign a Caregiver, include a completed and signed Caregiver Application on page 4 and 5
    • The Caregiver Application must be completed correctly
    • The designated caregiver/caregivers must provide a 2×2 photo
    • The designated caregiver must be selected at the time of application and submit a photo, proof of age, identity and residency.
    • Persons under age 18 who are diagnosed with a terminal illness may select a second caregiver by making a copy of pages 4 and 5 of the application and completing the requested information for the second designated caregiver
    • Caregivers for individuals who are diagnosed with terminal illness DO NOT have to pay an application fee
  4. A 2” x 2” photo of yourself
    • You can have the photo taken by a passport photo service, OR
    • You can have a friend take the photo, but use a plain white background, look straight into the camera and make sure your entire face shows in the photo
    • Do not use a “selfie”
    • No photograph is required for patients under age 18 who are diagnosed with terminal illness
  5. Provide proof of age, Identity and Residency
    • Submit a clear, color copy of your Illinois Driver’s License, Illinois Temporary Visitor’s Driver’s License, US Military ID, or Illinois State ID ( Minors – include a copy of your birth certificate )
    • The addresses on each ID document must match the address on your application
    • Do not send original ID documents – send only copies
  6. Check – and double-check – all your information and support documentation before mailing your package to:
    Illinois Department of Public Health
    Division of Medical Cannabis
    535 W. Jefferson St.
    Springfield, IL 62761-0001

If you have questions about your application, please call or email: DPH Division of Medical Cannabis, 855-636-3688 or DPH.MedicalCannabis@Illinois.gov.

*Unlike over 18 applications and other caregiver application forms a fingerprint-based background check is not required