Adults applying for a Delaware medical marijuana card on paper need page 2 of the patient application signed by a Delaware-licensed practitioner. The practitioner chooses a standard or terminal illness patient card and writes in the medical condition(s); since HB 285 (2024) there is no fixed qualifying list. Residents 65 and older may instead self-certify on the same page.
A Delaware-licensed MD, DO, APN or PA completes the entire Health Care Practitioner Certification section, including license details, specialty, identified condition(s) and signature. The patient completes page 1, or self-certifies at the bottom of page 2 if 65 or older.
Download the current version from the source each time; forms change without notice.
Health Care Practitioner Certification & Self Certification
If your copy of the form is a fillable PDF, upload it once and Vero Documents fills it from the visit note and the chart, ready for you to review and sign. Download, print, or email the finished form, with the patient’s consent.
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HB 285 (2024) removed Delaware's list of debilitating conditions. The practitioner identifies any medical condition they believe is likely to benefit, writes it on the certification and selects a standard or terminal illness patient card. Residents 65 and older may self-certify without a practitioner.
The completed application must reach the Medical Marijuana Program within 90 days of the practitioner's signature date. Online applications likewise require a visit with a registered practitioner within the past 90 days. Faxed or electronic copies of the paper certification are not accepted.
Yes. The certification accepts a Delaware-licensed MD, DO, APN or PA. The practitioner enters their medical license number, license type and specialty, identifies the patient's medical condition(s) and signs; the license state must be Delaware.