Helpful Forms

​Licensees and Registrants

Change of Business Name Request Form (Business name changes include conversion to LLC, C Corp., etc.)
  • ​​​​A licensee (Grower, Processor, Dispensary) or registrant (Independent Testing Laboratory, Security Guard Agency, Secure Transport Company, or Waste Disposal Company) must submit this form to request* Commission approval to change their business name.

* Because the Commission issues a license or registration to the business name that was included in the initial application materials, a licensee or independent laboratory testing registrant must submit a business name change request and wait for approval.

Note: Within five (5) business days of receiving Commission approval, a licensee or registrant must apply for a new license or registration certificate and pay the replacement fee ($100).
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​Change of Location Request Form
  • A licensee (Grower, Processor, Dispensary) or Independent Testing Laboratory must submit this form along with the change of location fee ($7,000), to request Commission approval to change their business location. COMAR 10.62.35.01 (A)(10)(b)

Note: A licensee may not begin cultivating, processing, or dispensing medical cannabis at a new location until they have passed all inspections. COMAR 10.62.08.09, 10.62.19.08, 10.62.25.09

  • A registrant (Security Guard Agency, Secure Transport Company, or Waste Disposal Company) must submit this form to notify the Commission that their business location has changed.

  • A licensee or registrant should submit this form to notify the Commission that their mailing address has changed.

  • A licensee or registrant should submit this form to notify the Commission that their authorized point-of-contact(s) has changed. Up to two (2) Authorized Point-of-Contacts per licensee or registrant are permitted.

  • A form for Medical Facilities that want to register through MMCC in order to administer medical cannabis to its qualifying patients/caregivers.

WHAT YOU’LL NEED TO PROVIDE: (We encourage you to preview the registration form in order to better prepare required information and documents.)
  • General Information about the Facility - Facility name, OHCQ license #, address, contact information.
  • Operating plan - Patient verification method, safety protocols for receiving/storing/administering medical cannabis, tracking methods, and diversion prevention. 
  • Complete & Notarized Forms - Authorization for Release of Information, Affidavit of Representative Applicant, and Acknowledgment and Disclosure.

  • A form for Third-Party Businesses that want to register through MMCC in order to work in conjunction with a Licensed Grower, Processor, or Dispensary.

​​WHAT YOU’LL NEED TO PROVIDE: (We encourage you to preview the registration form in order to better prepare required information and documents.)
  • General Information about the Business - Business name(s), address, contact information, business information, and authorized point-of-contact information. 
  • Incorporation/Formation Information - Incorporator/Founder details, Maryland SDAT, Status of Good Standing.
  • Business History - General information, diagram of premises and designated areas, diagram of limited access areas, diagram of security equipment areas, agreements with anyone who will share in the profits or proceeds of the business, conditional or contingent agreements related to profits/sales/etc. 
  • Ownership Structure - Detailed ownership information, details about previous or existing cannabis licenses or registrations anywhere, details about previous or existing cannabis business ownership anywhere.
  • Criminal History - Details about any previous or existing legal matters the business, owners, or employees have been involved in.
  • Financial History - Details about any existing or previous payment delinquencies, existing or previous violations of trust or security law (documents to show resolution of the issue), legal matters the business or any of its members have been involved in the previous five (5) years, audited/unaudited financial statements for the past two (2) years, financial statements for the past two (2) years, detailed list of operating and investment accounts, detailed list of outstanding loans and financial obligations.
  • Business Plan - Detailed long-term operating plan including facility description, scope of activities, budget and resources, operations ​timeline, employee working conditions/benefits/training, any other documents to demonstrate business’ ability to quickly and successfully enter the market.
  • ​Required Uploads (if applicable):
    • Appendix A: Independent Testing Laboratory (if applicable)
    • Appendix B: Security Guard Agency (if applicable)

​​​Providers

​​​Certifying Provider Compensation Request Form
  • ​​A certifying provider, who wants to receive compensation from a licensee, must submit this form to request* Commission approval for the compensation. COMAR 10.62.03.02
    • ​​A certifying provider must disclose the specific type of compensation, specific amount or value of compensation, and the services for which the compensation will be paid. COMAR 10.62.03.02(B)(1)
    • ​A certifying provider must also sign an attestation that the compensation does not violate the Maryland Medical Practice Act or the Patient referral laws. COMAR 10.62.03.02 (B)

Note: A certifying provider may not receive compensation* unless approved by the Commission.
* Compensation includes promotion, referral, recommendation, advertising, subsidized rent, or anything of value from a licensed grower, licensed processor, or a licensed dispensary. COMAR 10.62.03.02(A)



​​​​Patients


​​​HIPPA Authorization Form (Qualifying Adult Patient)
  • A qualifying adult patient or their caregiver may submit this form to authorize the Commission to release their medical information to a specific person or provider.

​​HIPPA Authorization Form (Qualifying Minor Patient)  -
  • ​A qualifying minor patient or their caregiver may submit this form to authorize the Commission to release their medical information to a specific person or provider.



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