Application Packet:

Application packets are available in English and Spanish at the San Bernardino County Department of Public Health office at 351 North Mountain View Avenue, 2nd Floor, in San Bernardino. Office hours are Monday to Friday, from 8:00 a.m. - 5:00 p.m., except holidays.

You can call to have an application packet mailed to you at 1 (800) 782 - 4264. To get an online application packet, go to www.sbcounty.gov/dph and click on the MMICP link.

Appointment:

Completed applications are accepted by appointment only. Appointments are scheduled Monday - Friday, 9:00 a.m. - 12:00 noon and 1:00 p.m. - 4:00 p.m. Please arrive on time. To schedule anappointment, call 1 (800) 782 - 4264.

Before Your Appointment:

1. Get written documentation from your physician recommending the use of medical marijuana as appropriate for one or more serious medical conditions. The physician can use the Written Documentation of Patient's Medical Record form, (download CDPH Form No. 9044), or official letterhead. Ensure a copy is in your medical file.

2. Complete an Application/Renewal form (download CDPH Form No. 9042).

3. Call to confirm your appointment at 1 (800) 782 - 4264.

4. Verify you have all items listed on the Appointment Check List below.

Bring to Your Appointment:

1. A completed original Application/Renewal form (download CDPH Form No. 9042).

2. The original written documentation from your physician recommending the use of medical marijuana on the Written Documentation of Patient's Medical Record form (download CDPH Form No. 9044), or official letterhead.

3. Your physician's name, contact information and California medical license number.

4. A government issued photo identification (i.e. California State Driver's License, a California State ID Card, United States Passport, Veteran's Administration ID Card).

5. Proof you live in San Bernardino County (i.e. current utility bill, or mortgage/rent payment receipt). A P.O. Box address is not acceptable for address verification.

6. Non-refundable application fee of $166, or $83 for Medi-Cal beneficiaries (qualified Medi-Cal participants get a 50% reduction in fees).
       - cash (Change in the exact amount is required.)
       - cashier check or money order.

7. Current Medi-Cal card if you are a Medi-Cal participant.

After Submitting Your Application:

It can take up to 35 days to receive your MMIC. To ensure delivery, we will contact you to pick-up your ID card when it is available. If you have any questions, please call 1 (800) 782 - 4264 or visit the Frequently Asked Questions link by going to www.sbcounty.gov/dph.