The department shall issue a registry identification card to a qualifying patient who submits the following, in accordance with rules promulgated by the department: (1) A written certification issued by a practitioner within ninety days immediately preceding the date of an application; (2) The application or renewal fee; (3) The name, address, and date of birth of the qualifying patient, except that if the applicant is homeless, no address is required; (4) The name, address, and telephone number of the qualifying patient's practitioner; (5) The name, address, and date of birth of the designated caregiver, or designated caregivers, chosen by the qualifying patient; (6) If more than one designated caregiver is designated at any given time, documentation demonstrating that a greater number of designated caregivers are needed due to the patient's age or medical condition; (7) The name of no more than two dispensaries that the qualifying patient designates, if any; and (8) If the qualifying patient designates a designated caregiver, a designation as to whether the qualifying patient or designated caregiver will be allowed under state law to possess and cultivate cannabis plants for the qualifying patient's medical use. When a practitioner conducts a follow-up assessment with a patient, within sixty days of issuing the patient a written certification, and the purpose of the follow-up assessment is to assess the patient's response to the use of medical cannabis and to determine whether to issue the patient a second written certification, the fee required under subdivision (2) is waived, if the patient reapplies for the second registry identification card. A patient may only receive one fee waiver under this section per calendar year.
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