Walk-ins are not accepted. To schedule an appointment, please call 408.792.5065.

Applications will be accepted by appointment only at the following location:

Public Health Administration
976 Lenzen Avenue (Second Floor)
San Jose, CA 95126

Once an appointment is made, the following items must be brought to your appointment:

1. A completed application. Forms can be downloaded and completed prior to your visit, or filled out before your appointment time.

   MMIC Application Forms:
   Application - English
   Application - Spanish

2. Government issued photo identification (i.e. California State Driver’s License, a California State ID Card, a United States Passport, a Veteran’s Administration ID Card).
3. Proof that you live in Santa Clara County, for example, the current photo IDs listed above, a recent utility bill, or a recent rental or mortgage payment receipt.

4. Written documentation completed by your physician that states that you have been diagnosed with a serious medical condition and that the medical use of marijuana is appropriate.

   Medical Condition Verification Forms for Physicians:
   Verification Form - English
   Verification Form - Spanish
   Physician form to document patient's medical condition for use of medical marijuana.

5. Cash or money order payable to the Santa Clara County Public Health Department in the amount of $150. If you have proof of Medi-Cal benefits, such as a current Medi-Cal card, the fees are reduced to $75. All Fees are non-refundable.

Note: Your photo will be taken on the day you submit your application.

All information contained in this website is subject to change without notice.