The Application for a Cannabidiol Registration Card is found at the bottom of the page.
The application is made available through this web site or by contacting the Iowa Department of Public Health at 515-281-5616 to request an application be mailed. A request for a mailed application can also be made by using the Contact Us function below the blue line at the bottom of this page. A request for the mailed application should include your name, phone number, and U.S. Postal mailing address.
The application may be printed and filled in by hand, or completed by saving the file to a computer and typing in the open text fields of the application.
Complete Section I - PATIENT INFORMATION.
Complete Section II - PRIMARY CAREGIVER INFORMATION.
If the patient is under 18 years of age or is age 18 or older, but is unable to manage his or her own care and use of Cannabidiol Oil, complete Section II - PRIMARY CAREGIVER INFORMATION. The application form will collect information for three primary caregiver applicants. If more than three primary caregivers will be included with the application, please access the Additional Caregiver Form found here. The Additional Caregiver Form(s) must be attached to the main application.
The Additional Caregiver Form can be found at the bottom of this page.
Print the application form and any Additional Caregiver Form(s) that are needed. Attach the Additional Caregiver Form(s) to the main application.
Attach one copy of the valid state-issued photo identification card or an alternative form of valid photo identification for the applicant patient (age 18 or older) and each primary caregiver applicant. A patient who possesses or is eligible for an Iowa driver’s license or an Iowa nonoperator’s identification card shall present such document as valid photo identification. A patient who is ineligible to obtain an Iowa driver’s license or an Iowa nonoperator’s identification card may apply for an exemption and request submission of an alternative form of valid photo identification. A patient who applies for an exemption is subject to verification of the patient’s identify through a process established by the department and the department of transportation to ensure the genuineness, and legality of the alternative form of valid photo identification.
Mail or deliver the application (Sections I and II completed) to the patient’s neurologist. Section III - NEUROLOGIST RECOMMENDATION must be completed by the patient’s neurologist.
Application for a Cannabidiol Registration Card requires a written recommendation from the patient’s neurologist. The neurologist who has examined and treated the patient with intractable epilepsy must provide, but has no duty to provide, the written recommendation for the patient’s use of cannabidiol.
Section III - NEUROLOGIST RECOMMENDATION is to be completed by the patient’s neurologist.
The completed application, containing the neurologist’s written recommendation, and the required copies of the valid state-issued identification card(s), must be mailed to the Iowa Department of Public Health by the neurologist or an authorized person from the neurologist’s office. The address for mailing the application is included on the first and last pages of the application form.
Review and Approval or Denial of the Application
Upon review and verification of the information contained in the application, Iowa Department of Public Health staff will mail a notification of approval to the patient, primary caregiver(s) and recommending neurologist. If the application is incomplete or otherwise does not meet the requirements, the Department will mail a request for the missing information or an application denial notice to the applicant.
The Department of Public Health may deny an application for a cannabidiol registration card for any of the following reasons:
1. Information contained in the application is illegible, incomplete, falsified, misleading, deceptive, or untrue.
2. The Department of Public Health or the Department of Transportation is unable to verify the identity of the applicant from the photo identification or other documentation presented pursuant to paragraph 154.3(1)“d”(2)“3” or 154.4(1)“c”(3)“4.”
3. The applicant violates or fails to satisfy any of the provisions of 2014 Iowa Acts, Senate File 2360, or these rules.
Adding Additional Primary Caregivers after the Patient’s Initial Application has been Approved
If a patient or a patient’s parent or legal guardian needs to designate another primary caregiver after the patient’s initial application has been approved, an Adding Additional Cannabidiol Primary Caregiver Registration Card Application must be completed and submitted to the Iowa Department of Public Health. The application can be found at the bottom of the page.
Questions about the Application Process?
Questions related to the application process may be directed to the Iowa Department of Public Health by calling 515-281-5616. All calls will be returned within 48 hours of receipt during regular office hours, Monday through Thursday, 8:00am - 4:30pm. Calls received on Fridays will be returned the following week.
Checking on the Status of Application?
1 - Application 2 - Attachment A - Additional Caregiver Form 3 - After Patient Approval - Additional Caregiver Form