Azdhs Dispensary Agent Registration

Identify each dispensary agent by providing his her last name first name and middle initial in the appropriate boxes on the form.

Azdhs dispensary agent registration. This portal to verify validate medical marijuana cards as well as submission of dispensary medical marijuana transactions. Principal officers and board members can apply directly for registration while employees and volunteers must have the dispensary entities make the application on their behalf. Fingerprinting instructions and the. Dispensary agent or po bm signature date signed.

When applying for registration dispensary agents must. The name of the dispensary agent to. Signature date signed. Although not part of the adhs online application a dispensary agent or member must submit fingerprints to adhs via the u s.

Please continue to check this website for updates on executive order 2020 43 and the process for receiving authorization to reopen after at least july 27 2020. Arizona department of health services. Dispensary agent registration and application instructions. If the applicant is issued a dispensary registration certificate the applicant agrees to not operate the dispensary until the dispensary is inspected and the applicant obtains an approval to operate from adhs.

The section below applies only to the dispensary principal officers and or board members. Dispensary agent registration o your role request will be approved automatically and your menu choices above will. I attest that the information provided to adhs for this dispensary registration certificate application is true and correct. Mail and include a fingerprint verification form.

All dispensary agents must be registered by the adhs whether they are working or volunteering at the dispensary. I attest that the information provided to adhs for this dispensary registration certificate renewal application is true and correct. Welcome to the az medical marijuana card verification point of sale system. In accordance with a r s.

For each dispensary agent provide the following. 2020 43 we are developing an attestation form where entities can attest they are in compliance with issued adhs guidance related to covid 19 business operations. Date of birth enter his her date of birth. The department may not issue more than one nonprofit medical marijuana dispensary registration certificate for every ten 10 pharmacies that have registered under section 32.

36 2804 nonprofit medical marijuana dispensaries shall register with the arizona department of health services department. I am designated to submit dispensary agent applications on the please print name legibly dispensary s behalf.