Applications and Forms

Registered Caregivers

Application Format
Instructions
Registered Caregivers
Revision Date
Caregiver Application
06/2022
DOCX, 139 KB N/A Caregiver Paper Application  06/2022
N/A
Registry Identification Card Change/Re-issue Form
06/2022

*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
8/11/2021
DOCX, 64 KB N/A Inherently Hazardous Substance Registration for Dispensary Applicants 8/11/2021
DOCX, 98 KB N/A Dispensary Local Authorization Form 10/8/2021
PDF, 385 KB N/A Maine Revenue Services - Tax Disclosure (Principals-Dispensary) 8/11/2021
DOCX, 42 KB N/A Officer or Director Registry Identification Card Application 8/12/2021

Caregiver and Dispensary Assistants

Application Format
Instructions
Caregiver and Dispensary Assistants
Revision Date
Online* PDF | HTML Registry Identification Card Application 6/2022
DOCX, 381 KB N/A Registry Identification Card Paper Application 5/2022
DOCX, 341 KB N/A Registration Identification Card Change/Reissue Form 5/2022
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.

Sample Forms

Application Format
Instructions
Sample Forms
Revision Date
N/A
Patient Designation Form
6/4/2020
N/A
Patient Transaction Log (Sample)
6/4/2020
DOCX, 77 KB HTML MMMP Trip Ticket 6/17/2020

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