Applications and Forms

Registered Caregivers

Application Format
Instructions
Registered Caregivers
Revision Date
Caregiver Application
06/2022
N/A
Caregiver Change/Re-Issue Form
02/2023

*Users completing a caregiver application online will be redirected to the Regulatory Licensing & Permitting website at Maine.gov. Upon request, the Office of Cannabis Policy may provide a print version of this form. Please note: Online applications are preferred and are able to be processed faster.

Registered Dispensaries

Application Format
Instructions
Registered Dispensaries
Revision Date
Dispensary Application
11/30/2022
DOCX, 190 KB N/A Inherently Hazardous Substance Registration for Dispensary Applicants 11/30/2022
DOCX, 195 KB N/A Dispensary Local Authorization Form 11/30/2022
PDF, 98 KB N/A Maine Revenue Services - Tax Disclosure (Principals-Dispensary) 8/11/2021

Caregiver and Dispensary Assistants

Application Format
Instructions
Caregiver and Dispensary Assistants
Revision Date
Online* PDF | HTML Registry Identification Card Application 6/2022
PDF, 155 KB N/A Registration Identification Card Change/Reissue Form 7/2022
DOCX, 342 KB N/A Authorization to Release Information 5/2022

 

*Users completing a registry identification card application online will be redirected to the Regulatory Licensing & Permitting website at Maine.gov. Please note: Online applications are preferred and are able to be processed faster. Upon request, the Office of Cannabis Policy may provide a print version of this form.

Sample Forms

Application Format
Instructions
Sample Forms
Revision Date

DOCX, 99 KB
PDF, 224 KB


HTML

MMCP Trip Ticket

10/04/2022
PDF, 146KB N/A Patient Designation Form 02/2023
PDF, 136KB N/A Patient Transaction Log (Sample) 04/2023

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