How to Apply - Patient Information

NEW! Click below to apply or to update an approved application Patient/Caregiver

Application Registration

Click on the Patient/Caregiver Application Registration blue box located under the photograph to apply for your identification card. If a “Warning-Exiting Site” pop-up box appears, click “Yes” to proceed to the registry. Only applications submitted through the on-line registry will be accepted. For more information, review 19 CSR 30-95.030. Qualifying Patient/Primary Caregiver. For information on how to enter and register patient and caregiver data into the on-line application, open the Patient Registry User Guide. NEW: Application Tutorial Guides

Each video focuses on a specific topic in the application process to assist patients and caregivers with creating and managing their application, such as how to enter physician and conditions information or to find and correct a rejected application.

Patient Forms

Steps to Licensure

Get started with the Application Checklist and Patient Registry UserGuide.

Step 1: Forms

To begin, patients will need the Physician Certification Form completed by an MD or DO in good standing in the state of Missouri.

For patients looking for the standard recommended dose of four (4) ounces per month, use the Standard Physician Certification Form.

Patients requiring more than the standard four (4) ounces should use the Alternative Physician Certification Form, and are required to submit two of these forms, completed by two different physicians, with the same qualifying medical condition selected on both forms. If the physicians’ recommended amounts listed on the forms are inconsistent, the patient will be allowed the lesser of those two amounts.

Patient that are under the age of 18 will also need to complete and submit a Parent/Legal Guardian Consent Form with their application.

Applying caregivers will need a Patient Authorization Form and the patient’s license number, which the patient will receive once their application is approved. This number will begin with PAT.

Step 2: Register

To complete an application, patients will need to register with the Complia application portal.

Click on the Patient/Caregiver Application Registration blue box located under the photograph to apply for your identification card. If a “Warning-Exiting Site” pop-up box appears, click “Yes” to proceed to the registry. Only applications submitted through the on-line registry will be accepted.

Step 3: Application

Once patients have registered, an application can be completed by logging into the Complia portal, clicking “+Create Application” and “New Patient Registration”.

Once caregivers have registered, an application can be completed by logging into the Complia portal, clicking “+Create Application” and “New Caregiver Registration”.

Note: The department has 30 days to process all submitted applications, and processes them in the order they were received.