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Form Name |
Requirements |
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Background Check Request | - Must be submitted for all persons listed on an application for a medical marijuana dispensary.
- Must be submitted in support of request to add a new owner and PRP.
- For details, visit the
Background Check page.
- All persons listed on an application for a medical marijuana dispensary registration must complete a background check request form. PRPs must submit separate background check request forms for each dispensary site they propose to serve.
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Electronic Fingerprint Authorization | |
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Individual History Form | - Must be submitted within
30 calendar days of new application payment.
- Required for each person listed on the application.
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Processor Endorsement Form | - Applicants seeking to register a processing site must identify their proposed endorsements on this form. This form is required for all applicants seeking a processor registration or any registrant seeking an additional endorsement type for an existing processor registration.
- Applicants and registrants completing this form should first review requirements for medical marijuana processors under
OAR 333-008-1600 through OAR 333-008-1830.
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Notification of Processing Site Readiness | - Do not submit this form prior to notification of meeting initial criteria.
- Must be submitted
within 60 days of notification from OHA that an application meets initial criteria.
- By
5:00 pm on the prescribed deadline, the form must be submitted using one of these methods:
- Uploaded to the application online,
or;
- Emailed to
medmj.dispensaries@dhsoha.state.or.us,
or;
- Mailed,
postmarked by 5:00 pm on the prescribed deadline, to:
- Oregon Medical Marijuana Program
- P.O. Box 14116
- Portland, OR 97293
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Extension Request for Processing Readiness | - Must be submitted
before your 60-day readiness deadline expires.
- The extension request must be for a reason outside your control, and you must provide supporting documents.
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Remove or Change a Person Responsible for a Processing Site (PRP) | - A PRP Remove or Change Form must be submitted to remove or change the designation of a PRP or Primary PRP.
- Failure to notify the Authority of a change of PRP, or if a PRP has resigned his/her position, may result in revocation of a dispensary registration.
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Add a Person Responsible for a Processing Site (PRP) | - Only submit this form when a PRP or primary PRP is
added.
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Transfer Authorization Form | - A Transfer Authorization Form must be used whenever unused marijuana is transferred by a grower or caregiver to a registered processing site.
- This form authorizes a specific person such a caregiver or grower to transfer unused marijuana on behalf of card holder.
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Transfer Authorization Form - Processor to Processor OR Dispensary | - This form authorizes a processing site to transfer
cannabinoid concentrate, extract, edible, transdermal patch, or suppositories to another processing site OR dispensary.
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Continuation of Operations by a Secured Party | - In the event of Foreclosure or Cessation of Operations, a Secured party may continue operations. This form allows to appoint such secured party.
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Request to Change Premises | - Must be submitted to seek approval from the Authority before making any physical changes that could substantially alter the premises from plans the Authority originally viewed.
- A floor or plot sketch must be attached with this request under OAR 333-008-1040(6)(b).
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Business Change | - Must be used whenever a registrant proposes to change its corporate structure, ownership structure or financial interest with an individual.
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Intake Form - Processor | - This form is required as the Processor Intake Form. It must be used in order to adhere to the intake transfer documentation rule requirements OAR 333-008-1760(5).
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