REGISTRATION CERTIFICATE APPLICATION 2026

1. Click ‘Get Form’ to open the REGISTRATION CERTIFICATE APPLICATION in the editor.
2. Begin by filling in the Dispensary’s Legal Name and Proposed Physical Address. Ensure that the address is an Arizona location, as P.O. Boxes are not acceptable.
3. Complete the Applying Entity Information section, specifying whether you are an individual, corporation, partnership, LLC, or other business organization. Provide a valid email address for notifications.
4. In the Medical Director Information section, enter the last name, first name, and license details of your medical director.
5. List all Principal Officers and Board Members by filling out their names and designations (PO/BM) in the designated fields. Use additional sheets if necessary.
6. Answer the Supplemental Requests questions regarding information submission permissions and financial documentation.
7. Finally, review all sections for accuracy before submitting your application along with any required documents listed at the end of the form.

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