Illinois Cannabis Tracking System

Registration Type
Patient - Opioid Alternative Pilot Program

User Information

Email Address (This email address will be the primary method of communication with the Illinois Department of Public Health. Please use an email address that will be checked regularly.)

Direct Email Address (The email address entered here should be your direct email address that no one else besides you has access to. Do not enter an email address that is shared with other providers or office staff)

First Name
Required

Middle Initial

Last Name
Required

Suffix

Username
Required

Last Four Digits of SSN
Required

Date of Birth
Required

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

Health Care Professional PIN

Health Care Professional - Provider Credentials

Type of Health Care Professional Licensure
Required

Licensing State
Required

National Provider ID Number
Required

Health Care Professional's License Number
Required

Health Care Professional - Office Contact Information

Office Address
Required

Office Apt/Suite/Floor/PO Box

Office City
Required

Office State
Required

Office County
Required

Office Zip Code
Required

Office Phone (The phone number entered here should be the main number to your practice)
Required

Direct Office Phone Number (The phone number entered here should be a direct line where you can be reached during business hours. Do not enter a main clinic, hospital, or clinic phone number)
Required

General Office Email Address (The email address entered here should be an email that is shared with other providers or office staff to receive information)

Health Care Professional - Confidentiality Agreement

I hereby certify that I have verified the above information to be accurate and complete and no one other than me is submitting this request.
I authorize the Illinois Department of Public Health, Medical Cannabis Pilot Program to contact me using the telephone number and email address I provided. I understand incomplete applications will not be accepted.

Electronic Signature
Required

By signing in to this system you are agreeing to the Website usage policy.

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 health care professional 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.

Be a resident of the State of Illinois at the time of application and remain a resident during participation in the program;
Have a qualifying debilitating medical condition;
Have a certification electronically submitted by a Health Care Professional for the use of medical cannabis;
Not hold a school bus permit or Commercial Driver's License;
Not be an active duty law enforcement officer, correctional officer, correctional probation officer or firefighter.

Exception: Veterans do not need to be certified by a registered ICTS health care professional if the following are met:

Currently receive continuing health care at a federal Veteran's Administration (VA) facility;
Hold a current prescription for an opioid issued by a VA health care professional

Please direct all questions to dph.oapp@illinois.gov.

Currently receive continuing health care at a federal Veteran's Administration (VA) facility;
Provide medical records from the VA facility about treatment for their qualifying debilitating medical condition for the last year.

Please direct all questions to dph.medicalcannabis@illinois.gov.
All communication from IDPH will be through email. Please mark dph.medicalcannabis@illinois.gov as a safe email address