Medical Cannabis Print Materials and Forms
Print Materials
- Minnesota Medical Cannabis Program: A Guide for Patients
- You're Registered with the Program...Now What?: A Guide for Patients - II (PDF)
- Minnesota Medical Cannabis Program: Health Care Practitioner Navigator I: Your Role & Responsibilities (PDF)
- Health Care Practitioner Navigator II: Register Yourself and Certify Patients (PDF)
- Caregivers' Companion: A Guide for Patients' Parents, Legal Guardians and Designated Caregivers (PDF)
- Public Safety Professionals' Primer (PDF)
Order Minnesota Office of Medical Cannabis Tri-Fold Brochures for use in your Office/Clinic/Department
- Order Minnesota Office of Medical Cannabis Tri-Folds
MDH has set up a way for you to order brochures for your practice, office or department free of charge with Flaire Print Communications, Inc. If you do this, you will be working directly with Flaire Print Communications, Inc., not MDH. We’re are doing this in the hope that it is convenient, not as an endorsement of Flaire Print Communications, Inc.
We can also provide you with electronic copies of the brochures, if you’d like to have them printed elsewhere.
*We are unable to approve orders above the quantity of 50 of each of the brochures. If you are requesting an order larger than that, please contact us at health.cannabis@state.mn.us.
Forms
- Designated Caregiver Background Check Informed Consent Form (PDF)
- Patient Email and Acknowledgment Form (PDF)
- Unauthorized Medical Cannabis Possession Report (Interactive PDF)
- Unauthorized Medical Cannabis Possession Report (PDF)
A licensed peace officer must complete this form to report an instance where an unauthorized individual is found to be in possession of medical cannabis. - MN Office of Medical Cannabis Complaint Form (Interactive PDF)
- MN Office of Medical Cannabis Complaint Form (PDF)
Use this form to report knowledge of a suspected violation of rules and/or statutes governing the Minnesota Medical Cannabis Program.
Completed forms may be mailed to:
Office of Medical Cannabis
PO Box 64882
St Paul, MN 55164-0882
Acknowledgment/Consent/Disclosure Documents
- Health Care Practitioner Patient Certification Acknowledgment (PDF)
- Health Care Practitioner Registration Acknowledgment (PDF)
- Parent or Legal Guardian Acknowledgment/Consent/Disclosure (PDF)
- Patient Tennessen Notice and Acknowledgment (PDF)
- Patient Information Document (PDF)
- Caregiver Acknowledgment/Consent/Disclosure (PDF)
- Pharmacist Acknowledgment/Consent/Disclosure (PDF)
- Pharmacy Receptionist or Technician Acknowledgment/Consent/Disclosure (PDF)
Reference Guides: Patient Registry
The reference guides listed below are tools that are designed to help provide assistance to each role that interacts with the MN Patient Registry. Each guide provides simple instructions along with corresponding screen shots of the MN Patient Registry of the most frequent activities that each role utilizes in the program.
- Adult Patient Enrollment (PDF)
This reference guide provides enrollment assistance to certified adult patients with a certified email notification to create an account.
- Minor Patient Enrollment (PDF)
This reference guide provides assistance to certified minor patients (or parents with a minor patient) with an invitation to create an account, parents may use the Minor Patient Enrollment reference guide to complete the enrollment in 9 steps.
- Patient Account Management (PDF)
Approved patients may use this guide to edit account information (update address and name, add/remove parent/legal guardian and caregiver), print/view the registry verification card, edit account settings (change password, email/username and security questions/answers), and complete self-evaluation reports.
- HCP Account Management (PDF)
Approved HCPs may use the HCP Account Management reference guide to manage the account settings (change password, email/username and security questions/answers), to certify or re-certify patients, allow for a caregiver, and complete patient experience surveys.
- Caregiver Registration (PDF)
This reference guide provides registration assistance for those who have been selected to serve as a caregiver for a patient.
- Caregiver Account Management (PDF)
Approved caregivers may utilize this guide to edit account information, print/view the registry verification card, and edit account settings in the MN Medical Cannabis Patient Registry.
- Reset Password (PDF)
This reference guide provides assistance in resetting a password if a password is forgotten or the user has a locked account.
Surveys
The Office of Medical Cannabis currently employs three surveys that are administered via the MN Medical Cannabis Patient Registry. These surveys enable patients and their certifying health care practitioner to provide critical feedback on the patient’s experience with the program.
Patient Surveys
- Patient Experience Survey (PDF)
Sent to patients 90 and 180 days after their first medical cannabis transaction, upon the patient’s annual program re-approval, and 180 days after re-approval.
- Health Care Practitioner Survey (PDF)
Sent to the certifying health care practitioner of each patient except those certified for intractable pain. It is sent 180 days after the patient’s first medical cannabis transaction, upon the patient’s annual program re-approval, and 180 days after re-approval.
- Health Care Practitioner Intractable Pain Survey (PDF)
Sent to the certifying health care practitioner of patients certified for intractable pain. It is sent 180 days after the patient’s first medical cannabis transaction and 180 days after annual patient re-approval.
- Health Care Practitioner Intractable Pain Re-approval Survey (PDF)
Sent to the certifying health care practitioner of patients certified for intractable pain. It is sent at annual patient re-approval.
Health Care Practitioner Surveys
