Arizona Medical Marijuana Reviewing Physician Form

Arizona requires a second physician's certification before a patient under 18 can get a medical marijuana registry card. On this one-page form, a physician other than the one who completed the main certification checks the minor's debilitating condition, confirms a comprehensive review of records from the minor's other treating physicians, and attests that the minor is likely to benefit.

Who completes it

A different Arizona-licensed MD, DO, naturopathic physician (NMD/ND) or homeopathic physician (MD(H)/DO(H)) completes and signs the whole form; the first physician completes the standard Medical Marijuana Physician Certification.

Submitting and payment

How to submit it
It is uploaded with the minor patient's online application in the ADHS Individual Licensing Portal, together with the primary Physician Certification.

Good to know

  • If the minor was referred to a dispensary, the reviewing physician discloses any personal or professional relationship with it to the custodial parent or legal guardian.
  • The condition checklist matches the main certification; for symptom-based conditions such as severe and chronic pain, write in the underlying chronic or debilitating disease.
  • The reviewing physician initials two statements, the records review and the dispensary disclosure, then signs the attestation of likely therapeutic or palliative benefit.

Get the official form

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

Medical Marijuana Reviewing Physician Certification

Fill it with Vero

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.

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.

Vero is not affiliated with, or endorsed by, the agencies and insurers listed here. Read our editorial policy.

Frequently asked questions

Can the same physician sign both Arizona certifications for a minor?

No. The Reviewing Physician Certification must come from a different Arizona-licensed physician than the one who completed the main Physician Certification. Both forms are uploaded together with the minor's online registry application in the ADHS Individual Licensing Portal.

What does the Arizona reviewing physician have to do?

Conduct a comprehensive review of the minor's medical records from other treating physicians, mark the qualifying condition, disclose any relationship with a referred dispensary to the custodial parent or guardian, and attest that the minor is likely to receive therapeutic or palliative benefit from medical marijuana.