MissKittyKat

How to Fill Out Health Canada Medical Marijuana Access Forms

2 posts in this topic

Many people need help with the MMAR forms that Health Canada has. If you make a mistake or do not complete it in such a way they will send it back and you won't get your license.

Here are the steps and what to do for each part of it.

STEPS:

1. Make an appointment with your doctor. He or she will need to fill out Form B1, or B2,

and sign your passport photos.

2. Get passport photos taken ( 2 ) you will need these for form A1. Your doctor will have

to sign the back of the photograph indicating that this is a true likeness of you.

Complete the Release Form for Medical Practitioners (This form is not mandatory and

can be left with your doctor for his/her records - Health Canada should not be sent this

form)

3. You should fill out this form before your appointment. (This form was written by The

Canadian Medical Protective Association, and in 2005 they issued this form to all the

doctors in Canada for this purpose) Your Canadian medical practitioner is released of

responsibility for the prescription of medical marihuana once they receive this document

filled in correctly.

· Print your name as the applicant

· Print the name of the doctor(s) that will be signing the Health Canada B1/B2 form

· Sign and date the document

· Get a witness to sign stating that they saw you the applicant sign the form, then

write the date beside the signature

· Take this completed form with you to your appointment with your doctor

4. Complete Health Canada Forms A, B1 or B2, and E1 (OR for growers - C, E2 & F)

Health Canada Form A

Application for Authorization to Possess Marihuana for Medical Purposes

A1 Cover Page

· Check the first box if it is your first time applying for a card.

· Check the second box for any other circumstance.

A1 Applicants information

· Indicate whether you use Mrs., Miss, Ms, or Mr.

· Print your full name: last, first, middle

· Put in your correct birth date: day, month, and year. (eg: 07 January 1945)

· Print your complete address starting with your house number, street/avenue if

you have an apartment number, fill it in, if not leave it blank.

· Put in your city, province and postal code

· Put a line through the next two lines (lot and concession number)

· Put a check to indicate this is a private residence in the box provided

A2 Photograph of Applicant

· Mark a check in the box indicating you have enclosed two copies of a current

photograph that clearly identifies you

· Mark a check in the box indicating one of these has been signed by the medical

practitioner signing the medical declaration who certifies that it is a true likeness

of you

A3 Appointed Representative

· You can choose to have an appointed representative, or you can leave this

section blank.

A4 Proposed Source of Marihuana

Mark a check in the box indicating that you plan to purchase your medication

from Health Canada. (This is due to the fact that Health Canada has not updated

the guidelines which would allow you to purchase from a 3rd party company - We

have been assured by Health Canada that they will have the reform completed

within 3 years and the forms will be updated at that time). You will then need to

complete an E1 form.

* If you are interested in obtaining a license to grow for yourself, please tick that

box instead and complete forms C, E2 and F if you are not the owner of your

home. .

·

A5 Authority to Communicate to Canadian Police

· There is nothing to complete in this section

A6 Declarations and Signature

· You will need to sign your name in full, print today’s date

· Print your full name

Health Canada Form B1

Medical Practitioner's Form for Category 1 Applicants

B1-1 Information on Medical Practitioner

· Your doctor will fill in the top part of this form

B1-2 Medical Condition and Symptoms

· Print your name, birth date and telephone number

· Your doctor will fill in the rest of this section

B1-3 Proposed Daily Amount

· This will be filled in by your doctor

B1-4 Duration

· This will be filled in by your doctor

B1-5 Medical Practitioner's Declaration and Signature

· This will be filled in by your doctor

Health Canada Form B2

Medical Practitioner's Form for Category 2 Applicants

B2-1 Information on Medical Practitioner

· Your doctor will fill in the top part of this form

B2-2 Medical Condition and Symptoms

· Print your name, birth date and telephone number

· Your doctor will fill in the rest of the information B2-3 Proposed Daily Amount

· This will be filled in by your doctor

B2-4 Duration

· This will be filled in by your doctor

B2-5 Medical Practitioners Declaration and Signature

· This will be filled in by your doctor

Health Canada Form E1

Application to Obtain Dried Marihuana

E1 Cover Page

· Check the first box indicating that you are applying for MMAR authorization.

E1 - 1 Applicant's Information

· Indicate whether you are Mrs., Miss, Ms, or Mr. by checking the correct square

· Print your correct birth date: day, month, and year (example 07 January 1945)

· Print your complete address starting with your house number, & street/avenue

(If you have an apartment number, fill it in, if not leave it blank. Next put your

city, province, and postal code)

· Print your home phone number, fax, and email address

E1 - 3 Delivery Instructions

· If you want to have product shipped to your address, put a check in the first box

· If you would prefer to have your doctor receive the medication, put a check in the

second box (you will need to provide the doctor's address)

E1 - 4 Declaration and Signature

· You will need to sign your name in full, print today's date.

· Print your full name.

Checklist for Marihuana Medical Access Regulations(MMAR) Application:

Health Canada Form A

Application for Authorization to Possess Marihuana for Medical Purposes

Passport photos signed by your medical practitioner

Health Canada Form B1

Medical Practitioner's Form for Category 1 Applicants

OR

Health Canada Form B2

Medical Practitioner's Form for Category 2 Applicants

Health Canada Form E1

Application to Obtain Dried Marihuana

MAKE A COPY OF ALL THESE DOCUMENTS FOR YOUR RECORDS

MAIL FORMS TO : Medical Marihuana Access Division, Drug Strategy and

Controlled Substances Program, Health Canada, 3503B, Ottawa Ontario, K1A1B9

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This looks like some helpful information for our Canadian and USA friends.

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