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CDPH 9044: Medical Marijuana Card Physician Statement

Californians applying to their county for a Medical Marijuana Identification Card can support the application with this optional two-page statement. The attending physician gives a California license number and licensing board, confirms the patient is under their care, and certifies a diagnosis from the listed conditions and that medical marijuana use is appropriate. The county calls the physician to verify it.

Who completes it

An attending physician licensed by the Medical Board of California or the Osteopathic Medical Board of California completes and signs the whole form. The patient, or a legal representative, completes the CDPH 9042 application, whose Section 5 names the same attending physician.

Submitting and payment

How to submit it
Give the original to the patient for the county health department or its designee with the CDPH 9042 application, and file a copy in the patient's medical record; the county then calls the physician to verify it, under Health and Safety Code 11362.72(a)(3).
Who pays
The patient pays the county's identification card fee, which is reduced for Medi-Cal beneficiaries.

Good to know

  • CDPH says the form is not mandatory. When used, it serves as the physician's written documentation of a serious medical condition and that medical marijuana use is appropriate.
  • Listed conditions are AIDS, anorexia, arthritis, cachexia, cancer, chronic pain, glaucoma, migraine, persistent muscle spasms, seizures, severe nausea, and other chronic or persistent symptoms that meet the form's criteria.
  • An other symptom qualifies if it substantially limits a major life activity as defined in the Americans with Disabilities Act of 1990, or may cause serious harm to safety or health if not alleviated.
  • The current revision is CDPH 9044 (1/2026). A denied applicant can appeal to CDPH on the CDPH 9043 within 30 calendar days of the county's denial notice, at no cost.

Get the official form

Download the current version from the source each time; forms change without notice.

Written Documentation of Patient's Medical Records

Documentación escrita de los expedientes médicos del/de la paciente

Official pagePDFVersión en español

How this list is checked

A form is listed only after its name and number were confirmed on the issuing agency’s or insurer’s own website, or in the form itself. Each entry links to that source. The list was last checked in October 2026. Forms and their requirements change without notice, so check the official page for the current version before you complete one.

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Frequently asked questions

Is CDPH 9044 required for a California medical marijuana card?

No. The form's note to the attending physician says it is not mandatory. If it is used, it serves as the physician's written documentation that the patient has a serious medical condition and that medical marijuana use is appropriate, and the patient submits it with the CDPH 9042 application to the county program.

Is CDPH 9044 available in Spanish?

Yes. CDPH posts CDPH 9044 SP, Documentación escrita de los expedientes médicos del/de la paciente, alongside the English form on its Medical Marijuana Identification Card Program Forms and Appeals page. The application (CDPH 9042) and appeals form (CDPH 9043) also have Spanish versions.

Will the county contact the physician who signed CDPH 9044?

Yes. If the patient applies through the county health department or its designee, the agency calls the attending physician to verify the information on the form, as Health and Safety Code section 11362.72(a)(3) provides. The physician keeps a copy in the patient's file and gives the original to the patient.