(1) An adult applicant, or a parent or guardian of a minor applicant, must have a Montana mailing address and submit an application form provided by the department for consideration to be placed in the state's confidential medical marijuana registry. An application form is available by contacting the Department of Public Health and Human Services, Licensure Bureau, 2401 Colonial Drive, Helena, MT 59620-2953. Application forms are also available on the department's web site at www.dphhs.mt.gov.

(2) Application materials that must be provided include:

(a) application fee;

(b) the applicant's name, address, date of birth, social security number, or state of Montana identification (ID) number;

(c) the name, address, date of birth, and social security number or state of Montana ID number of the applicant's designated caregiver, if any;

(d) the attending physician's signed and dated statement which includes their name, address, telephone number, Montana medical license number, and written certification attesting to the attending physician's diagnosis that the applicant has a debilitating medical condition as defined in 50-46-102, MCA.

(3) A copy of the relevant portions of an applicant's medical record may serve as the attending physician's written certification as long as it clearly states:

(a) the patient has been diagnosed by the attending physician with a qualifying debilitating medical condition;

(b) the medical use of marijuana may mitigate the symptoms or effects of the debilitating medical condition; and

(c) the date the medical record was made and the attending physician's signature.

(4) The signed and dated attending physician's statement or copies of chart notes or medical records must be current within three months of the date of an applicant's new or renewal application.

(5) The department will verify with the Montana Board of Medical Examiners that the attending physician is licensed to practice in the state of Montana, is currently on active status, and the license is in good standing.

(6) If the applicant wants to use a caregiver, a caregiver must be designated on the application. The caregiver must sign a statement agreeing to provide medical marijuana as needed and available only to those qualifying patients who have designated on their application that individual as their caregiver.

(7) The department will conduct a name-based criminal background check using the Montana Criminal Justice Information Network to verify that a person designated to be a caregiver has not been convicted of a felony drug offense in accordance with 50-46-103, MCA.

(8) The department will issue a registry identification card to an approved caregiver for each approved applicant who lists them as their caregiver.

(9) The department will either approve or deny an application within 15 working days of receipt of the application. If approved, the department shall issue a registry identification card to the applicant within five working days of approving the application.

(10) The registry identification card expires one year from the date of issuance and may be renewed.

(11) If the application is denied, the department will send the applicant notice of this denial and inform the applicant the reasons for denial.