Try for free

Michigan MMP 3500-4 Minor Physician Certifications

A Michigan patient under 18 needs certifications from two separate Michigan physicians to get a medical marijuana registry card. The minor packet contains two identical Physician Certification Forms, on pages 4 and 5, each listing qualifying conditions in Categories A to C. Each physician attests to a bona fide physician-patient relationship, a full assessment of history and current condition, and likely therapeutic or palliative benefit.

Who completes it

Two different MDs or DOs with current Michigan licenses each complete one Physician Certification Form, Sections A to D. The parent or legal guardian completes the application and the Declaration of Person Responsible for MINOR Patient.

Submitting and payment

How to submit it
The parent or guardian mails the complete packet in one envelope to the Michigan Medical Marijuana Program; the minor packet is a paper application. The application, declaration and both certifications must be signed and dated within six months of when the program receives them.
Who pays
The family pays the program's registry application fee; the form sets no fee for the physicians' evaluations.

Good to know

  • In the declaration, the parent confirms that the patient's physicians explained the potential risks and benefits of medical marijuana use to the patient and to the parent.
  • Only a parent or legal guardian aged 21 or older can be the caregiver, and proof of parentage or guardianship must be included or the application is denied.
  • White-out or any change on the application or either physician certification causes denial, so a corrected certification must be completed on a fresh form.
  • Categories match the adult form: Category A named diseases, Category B conditions producing symptoms such as seizures or severe nausea, and Category C conditions such as autism, PTSD and cerebral palsy.

Get the official form

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

MMMP Minor Application/Renewal Packet - Physician Certification Forms (two physicians)

Official pagePDF

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.

See how Vero Documents works

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

Why does a minor need two physician certifications in Michigan?

The minor packet requires two Physician Certification Forms completed and signed by two separate physicians, each an MD or DO with a current Michigan license. Each physician independently checks at least one qualifying condition and attests to a bona fide physician-patient relationship and a full assessment.

Can a minor's application be submitted online?

The minor packet gives paper instructions only: everything is mailed in one envelope by the parent or legal guardian. Online applications in the adult packet are limited to patients 18 and older applying without a caregiver, and a minor's parent or guardian must serve as caregiver.

How long is a minor's physician certification good for?

Each certification must be signed and dated within six months of the date the Michigan Medical Marijuana Program receives it, along with the application and the parent's declaration. A form signed earlier than that has to be redone.