How To Get A

Medical Card

Illinois Cannabis Patient Forms

Here you will find all official state forms and applications for the Illinois Medical Cannabis Pilot Program and the Illinois Opioid Alternative Pilot Program.

Instructions: Begin by visiting your physician and have him/her complete the Physician Certification Form (link to form found below). The physician will give you the completed form and you may then Sign Up online through the link below.

Signup Portal

Once submitted online, you will have a provisional card within 24 hours!

If you wish to apply by mail, you can print your forms from the links below.

Physician Certification Form
Patient Application
Caregiver Application
Dispensary Selection Form
Patient Application for Applicants under 18
Parent-Guardian Authorization Consent Form for Applicants Under 18 Years Old

Please feel free to stop by the store for any help with the application process.

If you have any questions about your application, please check with the Division of Medical Cannabis before sending it. Call them at 855-636-3688 or email them at DPH.MedicalCannabis@Illinois.gov.

Qualifying Conditions

  • Agitation of Alzheimer’s disease
  • HIV/AIDS
  • Amyotrophic lateral sclerosis (ALS)
  • Anorexia Nervosa
  • Arnold-Chiari malformation
  • Autism
  • Cancer
  • Causalgia
  • Chronic Inflammatory Demyelinating Polyneuropathy
  • Chronic Pain
  • Crohn’s disease
  • CRPS (complex regional pain syndrome Type II)
  • Dystonia
  • Ehlers-Danlos syndrome
  • Fibrous Dysplasia
  • Glaucoma
  • Hepatitis C
  • Hydrocephalus
  • Hydromyelia
  • Interstitial cystitis
  • Irritable Bowel syndrome
  • Lupus
  • Migraine
  • Multiple Sclerosis
  • Muscular Dystrophy
  • Myasthenia Gravis
  • Myoclonus
  • Nail-patella syndrome
  • Neuro-Bechet’s autoimmune disease
  • Neurofibromatosis
  • Neuropathy
  • Polycystic Kidney disease (PDK)
  • Parkinson’s disease
  • Post-Concussion Syndrome
  • Post-Traumatic Stress Disorder (PTSD)
  • Reflex sympathetic dystrophy
  • Residual limb pain
  • Rheumatoid arthritis
  • Seizures (including those characteristic of Epilepsy)
  • Severe fibromyalgia
  • Sjogren’s syndrome
  • Spinal cord disease (including but not limited to arachnoiditis)
  • Spinal cord injury is damage to the nervous tissue of the spinal cord with objective neurological indication of intractable spasticity
  • Spinocerebellar ataxia
  • Superior Canal Dehiscence syndrome
  • Syringomyelia
  • Tarlov cysts
  • Tourette syndrome
  • Traumatic brain injury
  • Ulcerative Colitis
  • Cachexia/wasting syndrome