Welcome to New Jersey Medical Marijuana Registry Homepage!

This site is not supported on a mobile device.

Please visit the website from a desktop or laptop computer. If you have any questions, please contact the customer service by clicking here or by calling at 609-292-0424.

BULLETIN BOARD

Notice: With the increase in volume of patients, the average turn around time for new patient registration is currently around two weeks.

 Physician Registration
 Personal Information
Last Name:
 First Name:
 Middle Name:
Date of Birth:
 
 Office Contact Information
Street1:
 Street2:
City:
 County:
 Municipality:
 State:   Zip:
   
Phone:
- -  Ext 		Fax:
- -
Alternate Phone:
- -  Ext 		Email:
 
 License Information
CDS Number:
 License Number:
NJ Medical Licensure Type:
 Specialty Type:
 Issuing State:
 
Address as on license:             Same as contact address
Street1:
 Street2:
City:
 State:                                Zip:
        
 
 User Access Information
Password is case-sensitive and must be 8-15 characters in length with at least one number or special character.
Desired User Name:
 Password:
 Re-type Password:
Secret Question:
 Secret Answer:
 
 Physician Agreement
I am a licensed physician in good standing in the State of New Jersey.
I have a current NJ CDS license.
  By submitting this form I accept the above Physician Agreement.
 
 Applicant Information
Applicant's Last Name:
 Applicant's First Name:
 Applicant's Title:
 
  This practice is not accepting new patients.
 
  Check here if you prefer that your name/practice not be publicly listed on our website.
 
     
Required Field