MMMP Patient Registration Verification

The MMMP registration verification process is simple and painless. Fill out the form below and upload a copy of your Michigan Medical Marijuana card front and back, your driver licenses front and back and a selfie with your driver licenses. You can either scan or your use your smartphone to take pictures. Upload may take up to a minute depending on the size of the files you are uploading. All information is strictly confidential. We must have this information before we can attempt and approve a delivery.

What We Need From You Before You Start, Take Photos of the Following:

State ID (drivers license or other picture government identification)
Copy of your valid State of Michigan MMMP card to verifying your eligibility.
Selfie with State ID (drivers license or other picture government identification)

Step 1 of 3

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Patient Information
Full Name*

First and Last Name
Address*
Street Address City State ZIP Code
Phone*
Phone Number?

MMMP Card Information
MMMP Card Registry Number*
What's Your Patient or Caregiver Registry Number?
MMMP Card Expiration Date*

When Does Your Card Expire?
Email*

Your Email Address.
What's on Your Mind?

Verification Pic Upload
Front Of MMMP Card*
Accepted file types: jpg, gif, png.
Upload Front Of MMMP Card. (jpg, gif, png)
Valid Michigan ID Front*
Accepted file types: jpg, gif, png.
Upload the Front of Your Driver Licenses.
Valid Michigan ID Back*
Accepted file types: jpg, gif, png.
Upload the Back of Your Driver Licenses.
Selfie with Michigan ID*
Accepted file types: jpg, gif, png.
Upload Selfie With Your Driver Licenses to Verify Identy.
Name
This field is for validation purposes and should be left unchanged.

When we drop off your first order, our driver will need to see your Michigan Medical Marijuana card and a valid Michigan driver licenses or Michigan ID that you uploaded.

MMMP Patient Registration Verification

What We Need From You Before You Start, Take Photos of the Following:

Step 1 of 3

Patient Information

MMMP Card Information

Verification Pic Upload

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