To prepare for this questionnaire, please have the following information ready:

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1. IF you have any proof of support benefits such as: 

• OHP

• SNAP/EBT

• Supplemental Security Income

• Military Veteran Status

 

*Please take a picture of these documents on a WHITE BACK GROUND, STRAIGHT, and IN FOCUS and have it stored on the device you are doing this questionnaire.

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2. Application fee to be paid:

Depending on whether you have support benefits, you will need to pay the OMMP application fee. Here are the fees - pick the LOWEST fee you qualify for:

• No benefits - Standard Fee $200

• SNAP/EBT $60

• OHP $50

• Military Veterans $20

• Supplemental Security Income $20

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3. Patient Information:

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You'll want images of your documents on your device to upload into this form. You can use your smart phone or tablet to take a picture of your ID.

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• Government Photo ID

  • Did you change your name? Send us a marriage certificate of court name change via this record upload: CLICK HERE UPLOAD

  • Do you have a NON-OREGON driver's license? You will need to provide Proof of Residency: CLICK FOR QUALIFIED PROOF

• Photo ID Number (ex. Driver's License Number)

• Date of Birth

• Mailing Address

• Phone Number

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4. Caregiver's Information (if it applies to your application)

• Same as above for patient

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5. Grower's Information (if it applies to your application)

• Same as above for patient 

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Growsite Information: (if it applies to your application)

• Is the grow site inside city limits?

• Is the grow site the Patient's Residence Address?

• Will the grower be transferring cannabis to a dispensary or processing facility (ie. selling the harvest)?

• Is grow site property owned by someone OTHER THAN the Patient or Grower?

  • If the Property Owner is OTHER THAN the grower or patient then you will need to forward a copy of the required Grow Site Consent Form to the OWNER to complete and mail DIRECTLY TO OMMP. You can copy this link below and email or text to the property owner