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    User Information


    Required

    Please create a 4-digit PIN. This number should be unique to you, and will be required each time you issue a Physician Certification.

    Physician - Proof of Identity



    Please provide your valid and current driver's license or state ID card information:

    Physician - Provider Credentials



    Physician - Office Contact Information




    Physician - Confidentiality Agreement




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    Qualifying patient must meet the following:
    • At least 21 years of age;
    • Illinois resident at time and during each 90-day registration period;
    • Certified by an Illinois Cannabis Tracking System (ICTS) registered physician that an opioid has been prescribed or could be prescribed;
    • Not hold a school bus permit or Commercial Driver's License (CDL);
    • Not be an active duty law enforcement officer, correctional officer, correctional probation officer, or firefighter.