Haw. Code R. § 11-160-16 - Qualifying patient and primary caregiver registration requirements
(a) To apply for or renew a qualifying
patient's registration, an applicant shall submit the following to the
department on a form and in a manner prescribed by the department:
(1) The qualifying patient's full name,
residential, mailing, and email addresses, date of birth, and
signature;
(2) For a qualifying
patient who is a minor or an adult lacking legal capacity, the full name,
residential, mailing, and email addresses, and date of birth of a parent,
guardian, or person having legal custody of the minor or the adult lacking
legal capacity;
(3) A written
certification from the qualifying patient's certifying physician or certifying
advanced practice registered nurse;
(4) A statement of whether the qualifying
patient or the primary caregiver will be cultivating cannabis, if at all, for
the qualifying patient's use;
(5)
The location of the grow site, if any;
(6) Whether the qualifying patient or the
primary caregiver is claiming the grow site as the qualifying patient's or
primary caregiver's residential address or other location under the qualifying
patient's or primary caregiver's ownership or control;
(7) An attestation by the qualifying patient
or the primary caregiver that the qualifying patient or the primary caregiver
resides at, owns, or controls the grow site;
(8) A clear photocopy of the qualifying
patient's identification document showing the patient identification
number;
(9) A consent by the
qualifying patient or the qualifying patient's parent, guardian, or person
having legal custody of the qualifying patient if the qualifying patient is a
minor or an adult lacking legal capacity, for the certifying physician or
certifying advanced practice registered nurse to release health information
pertaining to the qualifying patient's debilitating medical condition to the
department for the purpose of registration, monitoring, or
investigation;
(10) If the
qualifying patient is a minor or an adult lacking legal capacity, written
consent by the parent, guardian, or person having legal custody of the
qualifying patient to:
(A) Allow the
qualifying patient's medical use of cannabis;
(B) Serve as the qualifying patient's primary
caregiver; and
(C) Control the
acquisition of the cannabis, the dosage, and the frequency of the medical use
of cannabis by the qualifying patient;
(11) If the qualifying patient is a minor or
an adult lacking legal capacity, an attestation by the person applying to
register the minor or the adult lacking legal capacity that the person is a
parent, guardian, or person having legal custody; provided that the department
may require documentation confirming the legal status of the parent, guardian,
or person having legal custody of the qualifying patient, including, but not
limited to, a birth certificate, power of attorney, guardianship documents,
divorce decrees, or other court orders;
(12) An attestation that the information
provided in the application is true and correct;
(13) An attestation that the qualifying
patient has read, understands, and agrees to abide by part IX of chapter
329, HRS, and this chapter;
(14) Payment of registration fees in
accordance with section
11-160-17;
and
(15) Any other information
reasonably required by the department to process a qualifying patient's
registration, to determine the qualifying patient's suitability for
registration, or to protect public health and safety.
(b) If the qualifying patient is designating
a primary caregiver, an applicant shall submit the following to the department
on a form and in a manner prescribed by the department:
(1) The primary caregiver's full name,
residential and mailing addresses, date of birth, and signature;
(2) A photocopy of the primary caregiver's
valid driver's license issued by a state or territory of the United States or
the District of Columbia, identification card with photo issued by a state or
territory of the United States or the District of Columbia, or current
passport;
(3) An attestation by the
primary caregiver that the primary caregiver agrees to undertake responsibility
for managing the well-being of the qualifying patient with respect to the
medical use of cannabis;
(4) An
attestation by the primary caregiver that the primary caregiver meets all of
the primary caregiver requirements pursuant to section
11-160-26;
and
(5) Any other information
reasonably required by the department to process a qualifying patient's
registration, to determine the qualifying patient's suitability for
registration, or to protect public health and safety.
(c) The department may register two primary
caregivers for a qualifying patient who is a minor; provided that each primary
caregiver is a parent, guardian, or person having legal custody of the
qualifying patient; provided further that each primary caregiver shall comply
with subsection (b) and sections
11-160-26 and
11-160-27.
Notes
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