Application Process
When a patient applies for a Medical Marijuana Identification Card, they must provide all of the following:
- Completed application
- Recommendation from their physician stating that the patient has a serious medical condition and that medical use of marijuana would be appropriate
- Government-issued photo ID
- Phone or utility bill that includes a current Alameda County address
- $100 fee. Applicants on MediCal will be charged $50.
Please see contact information for additional information on how to proceed.
Medical Marijuana Program Application/Renewal Form – DHS 9042 (English)
https://www.cdph.ca.gov/CDPH%20Document%20Library/ControlledForms/cdph9042.pdf
Medical Marijuana Program Application/Renewal Form – DHS 9042 (Spanish)
https://www.cdph.ca.gov/CDPH%20Document%20Library/ControlledForms/cdph9042sp.pdf
Written Documentation of Patient’s Medical Records – DHS 9044 (English)
https://www.cdph.ca.gov/CDPH%20Document%20Library/ControlledForms/cdph9044.pdf
Written Documentation of Patient’s Medical Records – DHS 9044 (Spanish)
https://www.cdph.ca.gov/CDPH%20Document%20Library/ControlledForms/cdph9044sp.pdf
Denial Appeals Application (English)
https://www.cdph.ca.gov/CDPH%20Document%20Library/ControlledForms/cdph9043.pdf
Denial Appeals Application (Spanish Version)
https://www.cdph.ca.gov/CDPH%20Document%20Library/ControlledForms/cdph9043sp.pdf