(1) All applicants must have a Montana mailing address and submit an application packet on forms provided by the department for consideration to be placed in the registry.

(2) Application forms are available from and must be submitted to the Department of Public Health and Human Services, Licensure Bureau, 2401 Colonial Drive, P.O. Box 202953, Helena, MT 59620-2953. Application forms are also available on the department's web site at www.dphhs.mt.gov/marijuana.

(3) Registered cardholder application materials that must be provided include:

(a) State of Montana Marijuana Registered Cardholder Application Form. The information on this form includes:

(i) the applicant's name, address, date of birth, and social security number;

(ii) verification that the applicant:

(A) will cultivate and manufacture marijuana for the applicant's own use; or

(B) will obtain marijuana from a provider or marijuana-infused products provider.

(iii) verification that the applicant agrees to not divert to any other person the marijuana that the applicant cultivates, manufactures, or obtains for the applicant's debilitating medical condition; and

(iv) verification that the applicant is not in the custody of, or under the supervision of, the Montana Department of Corrections (DOC) or a youth court.

(b) proof of residency;

(c) signed, applicable Physician Statement attesting to the applicant's diagnosis of a debilitating medical condition as defined in 50-46-302, MCA, diagnosis of chronic pain, or certification for use by a minor. The Physician Statement includes:

(i) physician's name, address, and telephone number; and

(ii) physician's Montana medical license number.

(d) applicable fees as outlined in ARM 37.107.117; and

(e) landlord permission form, if applicable.

(4) The department will verify with the Montana Board of Medical Examiners that the attending physician, and, if applicable, the referral physician, are licensed to practice medicine in Montana and the license is in good standing.

(5) The department must either approve or deny a registered cardholder application within 30 business days of receiving completed application materials. If approved, the department must issue a registry identification card within five business days of approving the application.

(6) Applicants who designate, on the application form, a provider or a MIPP who is not already registered with the department, will be issued a registry identification card listing no provider or MIPP.

(a) Named providers or MIPPs who are not already registered with the department will be required to submit application materials and be approved for the registry by the department, before they can be a provider or MIPP.

(b) Upon approval by the department, the registered cardholder will be issued a new card with the name of the registered provider or MIPP.

(7) The registry identification card expires one year from the date of issuance except when:

(a) the physician statement provides a written certification for a shorter period of time; or

(b) a registered cardholder changes provider or MIPP. When a change request form is received, processed, and approved by the department the registered cardholder's current card becomes void. The new card is not valid until it is received by the registered cardholder.

(8) Incomplete application packets will be handled pursuant to ARM 37.107.121.

(9) If the registered cardholder application is denied, the department will send the applicant notice of and reasons for the denial. Rejection of the application is considered a final department action, subject to judicial review.