For Physicians

The Illinois Compassionate Use of Medical Cannabis Pilot Program requires physicians to certify the diagnosis of a debilitating condition or terminal illness for a qualifying patient seeking to apply for a medical cannabis

WHAT DO I NEED TO KNOW?

You must be a doctor of medicine or osteopathy licensed under the Medical Practice Act of 1987, have a controlled substances license under Article III of Illinois Controlled Substances Act, be in good standing to practice medicine in Illinois, and have a bona fide physician-patient relationship with the patient whose debilitating condition they are certifying.

* Whether or not a physician chooses to provide a written physician certification is up to the health care practitioner.

Qualifying Debilitating Medical Conditions Under Illinois State Law

  • Acquired Immunodeficiency Syndrome (AIDS)
  • Agitation of Alzheimer's disease
  • Amyotrophic Lateral Sclerosis (ALS)
  • Arnold-Chiari malformation and Syringomelia
  • Cachexia/wasting syndrome
  • Cancer

PROCESS FOR COMPLETING A WRITTEN PHYSICIAN CERTIFICATION

All qualifying patients who apply for a medical cannabis registry identification card must have their debilitating medical condition certified by a physician once every three years. The physician must:
Have a bona-fide physician-patient relationship with the qualifying patient. The bona-fide physician-patient relationship may not be limited to issuing a written certification for the patient or a consultation simply for that purpose.
Have responsibility for the ongoing care and treatment of the qualifying patient's debilitating condition, provided that the ongoing treatment and care shall not be limited to or for the primary purpose of certifying a debilitating medical condition or providing a consultation solely for that purpose.
Complete an in-person full assessment of the patient's medical history and current medical condition, including a personal physical examination, not more than 90 days prior to making the certification for medical cannabis. The assessment of the qualifying patient's current medical condition shall include, but not be limited to, symptoms, signs and diagnostic testing related to the debilitating medical condition.
Certify that the qualifying patient is under the physician's care, either for the qualifying patient's primary care or for his or her debilitating medical condition or symptoms of a debilitating medical condition.

PROCESS FOR COMPLETING A WRITTEN PHYSICIAN CERTIFICATION

All qualifying patients who apply for a medical cannabis registry identification card must have their debilitating medical condition certified by a physician once every three years. The physician must:
Have a bona-fide physician-patient relationship with the qualifying patient. The bona-fide physician-patient relationship may not be limited to issuing a written certification for the patient or a consultation simply for that purpose.
Have responsibility for the ongoing care and treatment of the qualifying patient's debilitating condition, provided that the ongoing treatment and care shall not be limited to or for the primary purpose of certifying a debilitating medical condition or providing a consultation solely for that purpose.
Complete an in-person full assessment of the patient's medical history and current medical condition, including a personal physical examination, not more than 90 days prior to making the certification for medical cannabis. The assessment of the qualifying patient's current medical condition shall include, but not be limited to, symptoms, signs and diagnostic testing related to the debilitating medical condition.
Certify that the qualifying patient is under the physician's care, either for the qualifying patient's primary care or for his or her debilitating medical condition or symptoms of a debilitating medical condition.

HOW TO SUBMIT A WRITTEN CERTIFICATION FOR A QUALIFYING PATIENT

The physician must complete the physician written certification document and sign it in blue ink.

* DO NOT give this form to the patient.

SEND REGULAR MAIL

Illinois Department of Public Health

Division of Medical Cannabis

535 W. Jefferson Street

Springfield, IL 62761

SEND VIA EMAIL

A COLOR scan (.pdf only) may be emailed to DPH.DebilitatingConditions@illinois.gov. The message section of the email must contain contact information for the physician, physician’s office and staff person sending the emailed form.

FAQ

Does the physician provide the qualifying patient with a prescription specifying the dosage appropriate for medical cannabis use? No. The physician written certification does not constitute a prescription for medical cannabis. Does IDPH provide a list of medical providers who will certify patients for the medical cannabis program? No. IDPH will not maintain or publish a list of practitioners who issue physician certifications. Can a physician charge for a physician written certification? Qualifying patients do not need to pay a special fee to their physician for the physician written certification. The physician may accept payment for the fee associated with the personal physical examination required prior to issuing the written certification. How much medical cannabis can a registered qualifying patient purchase? A registered qualifying patient may purchase up to 2.5 ounces of medical cannabis during a 14-day period. This amount of medical cannabis, called the “adequate supply,” is defined in Section 10 of the Act. Purchases of medical cannabis can only be made at a licensed medical cannabis dispensary. Can the physician revoke or rescind the written certification for a registered qualifying patient? Changes made to the Compassionate Use of Medical Cannabis Pilot Program Act in July 2016 (Public Act 099-0519) removed the physician’s ability to revoke or rescind the physician certification. The physician certification shall be valid for the duration of the three-year period of the medical cannabis registry identification card.

* If you are completing the written certification by hand, please clearly print the patient’s full name and date of birth.

* Whether or not a physician chooses to provide a written physician certification is up to the health care practitioner.

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