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How to use or fill out Illinois Medical Cannabis Verification Form
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Click ‘Get Form’ to open it in the editor.
Begin by entering your phone number and printing your name in the designated fields under 'TO BE COMPLETED BY THE PETITIONER'.
Fill in your Driver’s License Number and affirm your enrollment in the Medical Cannabis Pilot Program by checking the appropriate boxes regarding your status.
Sign and date the form at the bottom of this section.
Proceed to the physician's section. The physician should print their name, address, telephone number, and medical license number.
The physician must confirm details about your treatment and sign with the date.
If applicable, complete the section for the primary substance abuse/alcoholism treatment provider, ensuring all required information is filled out accurately.
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