Section 1: Qualifying Patient Information
Section 1 of the MMMP Designation form asks for personal information including; name (first and last), date of birth, address, phone number, etc. Additionally, it asks for information that can be found on the certification issued by your medical provider, including; certifying provider’s name, the issue date of the certification, and the expiration date of the certification.
No, any and all information you share with your designated dispensary is for internal use only and will remain confidential per Maine State law.
Section 1 should be filled out with the certified patient’s information only; guardians/caretakers should fill out Section 3B: Non-Cultivating Caregiver Information.
If all fields are not filled by your provider, your certification will not be accepted. Please reach out to your medical provider ahead of your visit to get your certification completed and thus avoid an infructuous visit.
Section 2: Cultivation Designation
The State of Maine allows every certified patient access to the amount of medicine 6 mature, harvestable cannabis plants produce – this equates to 2.5oz in any 15 day period. This 2.5oz can be harvested from plants a patient grows on their own, or it can be purchased from a dispensary or caregiver. In order to purchase medicine from a dispensary or caregiver, a patient must “designate” (authorize to grow) some, or all, of the 6 plants they’re allowed to grow to that dispensary/caregiver to grow on their behalf.
Technically, yes. Because the law states that patients may only have access to 6 harvestable plants, you could designate with a dispensary/caregiver while the plants you grow at home are in a seedling/vegetative state. You would have to alert your designated dispensary/caregiver when your plants are harvestable, however, so they can stop growing plants for you.
Plants are considered harvestable during the late stages of the flowering period, when the buds/flowers are fully developed. Certain characteristics of the plant may continue to change at this point (maturity of trichomes and cannabinoids), but it has reached its maximum size/yield.
You may choose to designate any number 1-6 with a dispensary/caregiver, and grow the rest at home.
The State of Maine allows patients to grow all of their own medicine, have a dispensary/caregiver grow all of their medicine, or split their plants between themselves and a dispensary/caregiver – it does not allow patients to designate multiple dispensaries/caregivers at the same time.
The number of plants you designate with a dispensary/caregiver determines how much medicine (of the total 2.5oz legal maximum) you may buy from them within a 15 day period.
No dispensary/caregiver is able to dispense medicine to a patient who has not designated at least one plant. However, you may choose to change the number of plants you’ve designated at any time, and do not sacrifice the right to grow your own medicine by designating with a provider.
A visiting qualifying patient (VQP) is a non-Maine resident who is certified for medical marijuana use in their home state, and is designating with a provider in Maine while they reside in Maine.
Section 3A: Cultivating Caregiver Information
This section is intended for patients/caregivers to fill out when they designate a caregiver to grow medicine on their behalf. The caregiver’s information, including name, phone number, address, etc. must be filled out before purchasing any medicine.
If you are designating with a WCM dispensary, you may leave this field blank.
Section 3B: Non-Cultivating Caregiver Information
The State of Maine allows every certified patient to designate 1 individual, who is usually a family member or roommate, to be able to purchase medicine on their behalf if they are personally unable to.
Anyone you designate as a Non-Cultivating Caregiver must be a Maine resident and at least 21 years of age, and ideally a family member or someone with whom you share a residence. You may designate someone who does not live with you or share a family relation, but they are required to apply to the Department of Health and Human Services and submit to a criminal background check before they are approved.
Section 4: Dispensary Information
This section is intended for patients/dispensary staff to fill out when they designate a dispensary to grow medicine on their behalf. The dispensary’s information, including name, address, phone number, name of dispensary representative, etc. must be filled out before purchasing any medicine.
If you choose to designate with a WCM dispensary, our friendly staff will complete this information for you.
Section 5: Patient Rights and Responsibilities
This section outlines your rights and responsibilities as a certified medical marijuana patient, including: your obligation to provide your designated provider with your original designation card, your right to take a copy of any documentation you have provided your designated medical marijuana provider, and your right to terminate your relationship with a designated provider at any time. Please read all of the information in this section to ensure that you understand, and agree with, your rights and responsibilities.
The designee is the WCM dispensary representative who will review your paperwork upon your designation with one of our facilities.
All providers assign each of their patients with an ID number upon designation. This allows WCM to label your plants and customer profile per state law while protecting your confidentiality.