"Attending Provider Statement" or "APS" means the form, prescribed by the Authority and signed by an attending provider that states the individual has been diagnosed with a debilitating medical condition and that the medical use of marijuana may mitigate the symptoms or effects of the individual’s debilitating medical condition.
You may submit alternate medical documentation (i.e. chart notes) but they must be signed by an attending provider, dated within 90 days and explicitly state that you have been diagnosed with a qualifying medical condition and that the medical use of marijuana may mitigate the symptoms or effects of your debilitating medical condition.
Some attending providers are required to provide you with additional medical documentation. If your attending provider gives you additional medical documentation with your APS, you must upload that as well.
Click here to see a sample Attending Provider Statement and additional medical documentation form. You must upload your medical documentation.
All medical documentation must be signed by your attending provider no more than 90 days from the day the OMMP receives it.

A Doctor of Medicine (MD), Doctor of Osteopathy (DO), Physician Assistant (PA), Clinical Nurse Specialist (CNS), Certified Registered Nurse Anesthetist (CRNA), Nurse Practitioner (NP), or Naturopathic Physician (ND) who has primary responsibility for the care and treatment of a person diagnosed with a debilitating medical condition.
You may confirm your MD's or DO’s license status on the Oregon Medical Board website.

If you are an applicant under the age of 18, you must designate your Custodial Parent or Legal Guardian as your caregiver on your application. You must also upload a notarized Declaration of Person Responsible for a Minor form signed by your caregiver.
Click here for a copy of the Declaration of Person Responsible for a Minor form.

If you are a renewing applicant and a veteran who has either,

• been assigned a total and permanent disability rating for compensation rating you as unable to secure or follow a substantially gainful occupation as a result of service-connected disabilities as described in 38 C.F.R. 4.16; or
• has a United States Department of Veterans Affairs total disability rating of 100 percent as a result of an injury or illness that the veteran incurred, or that was aggravated, during active military service and who received a discharge or release under other than dishonorable conditions,

then you are not required to submit subsequent annual medical documentation required under ORS 475C.783(11)(b).
For more information please see Senate Bill 1524 or ORS 475C.783(11)(b).
You must upload proof of meeting this criteria.

OMMP patients must provide proof of Oregon residency by providing one of the following:

• Oregon issued identification; or
• Other acceptable identification and residency proof such as current tax return, utility bill, lease, mortgage or rental agreement showing their current Oregon address.

Your Government Identification Number can be found on your state driver license or state identification card, military identification or passport.
If your government identification number contains characters or spaces, you must enter it exactly as it appears on the document.
You must upload government identification for yourself and any other individual listed on your application such as a caregiver or grower.

This is your valid government issued photographic identification that includes your last name, first name, date of birth and expiration date. Common types submitted are copies of driver licenses, state identification, passports and military identification.
You must upload government identification for yourself and any other individual listed on your application such as a caregiver or grower.

A card number provided to the patient by the OMMP following a successful application. The card number is found on your Patient Card .

Registration numbers are issued after an application is received. It is the number which follows a forward slash ( / ). For example 1111/123456, your registration number would be 123456. You can find your registration number on the placard that comes with your Patient Card or in the subject line and footers of OMMP letters.

Qualifying Debilitating Medical Conditions:

• Malignant neoplasm (Cancer);
• Glaucoma;
• Positive status for Human Immunodeficiency Virus (HIV) or Acquired Immune Deficiency Syndrome (AIDS);
• A degenerative or pervasive neurological condition;
• Post-Traumatic Stress Disorder (PTSD); or
• A medical condition or treatment for a medical condition that produces for a specific patient one or more of the following:
• Cachexia;
• Severe pain;
• Severe nausea;
• Seizures, including but not limited to seizures caused by epilepsy;
• Persistent muscle spasms, including but not limited to spasms caused by multiple sclerosis.

"Designated primary caregiver" means an individual who is 18 years of age or older and has significant responsibility for managing the well-being of a person who has been diagnosed with a debilitating medical condition. "Designated primary caregiver" does not include a person's attending provider.
Designation of a caregiver is optional if the patient is 18 or older.
If you designate a caregiver you must upload a copy of his or her current government identification.

A grower is an individual designated by a patient to produce their marijuana. Designation of a grower/grow site is optional.

If you had a legal name change since your last application you must submit proof of the name change. Proof can be in the form of government identification with your new name that the OMMP can match with the same identification number already on file with your old name, or government identification with your old name and a copy of the legal documentation showing your new name (marriage, dissolution or citizenship).

You cannot renew more than 90 days before your patient card expires.
Medical documentation must be signed by your attending provider no more than 90 days prior to the expiration date of your current patient card and
no more than 90 days from the day the OMMP receives it.

If you already submitted an online application but you did not upload sufficient medical documentation you will not be able to reapply. Please MAIL your current medical documentation to the OMMP at PO Box 14450, Portland, OR 97293-0450. You will receive a letter from the OMMP requesting medical documentation and any other missing information or fees.

The default Application Fee is $200.

An applicant currently eligible for Oregon Health Plan (OHP) benefits may qualify for a reduced application fee of $50.
You must upload current proof of your current OHP receipt.
Click here to see samples of acceptable OHP proof you may submit.

An applicant currently receiving food stamp benefits through the Oregon SNAP qualifies for a reduced application fee of $60.
You must upload current proof of your current SNAP receipt.
Click here to see samples of acceptable SNAP proof you may submit.

An applicant currently receiving Supplemental Security Income (SSI) benefits qualifies for a reduced application fee of $20.
You must upload current proof of your SSI benefit.
Click here to see samples of acceptable SSI proof you may submit.
Note: Social Security Disability Income (SSDI) and retirement benefits (SSB, etc...) do not qualify for a reduced fee.

An applicant who has served in the Armed Forces of the United States qualifies for a reduced application fee of $20. In order to qualify for the reduced fee you must upload proof of having served in the Armed Forces, such as but not limited to, submitting a Veteran’s Administration form DD-214.
Click here to see samples of acceptable Armed Forces proof you may submit.

US armed forces service members with a US Department of Veterans Affairs total disability rating of at least 50% as a result of an injury or illness that the veteran incurred, or that was aggravated, during active military services and who received a discharge or release under other than dishonorable conditions qualify for application fee waiver under OAR 333-008-0021(1)(e).
Click here to see samples of acceptable Armed Forces proof you may submit.

Unable to connect to your patient information? Please review the following troubleshooting tips:

• Did you refer to your last-issued OMMP card and enter your name exactly the way it appears? For example: “JONATHAN L DOE”.
• Did you include your full last name as it appears on your last-issued OMMP card, including hyphenated names, JR, II, 2nd, etcetera? For example: “JONATHAN L DOE-REMI JR” (Note: If there is no hyphen or period in your name on your last-issued card do not use one.)
• Did you use your full first name (no nicknames)? For example: “JONATHAN” not “JON”.
• Did you include your middle initial (if you have one) exactly as it appears on the government ID you last submitted to the OMMP? Do not use a period when entering. For example: “JONATHAN L DOE”.
• Did you enter the government ID number from the government ID you last submitted to the OMMP? Do not include the state abbreviation unless it is included in your ID number. If your government ID number contains characters or spaces you must enter the number exactly as it appears. As an example, an Oregon ID or driver license would be entered as: “123456” not “OR123456”.
• Are you entering the number from your patient card? (Not your caregiver or grower card.)
• Are you entering the number in the correct location? Enter registration number in the registration box and patient card number in the patient box.
• Be sure there are no extra spaces before or after the number you enter.

Still having trouble? Contact the OMMP by email at ommp.info@dhsoha.state.or.us or by phone at 971-673-1234.