Forms
Kentucky In-State Patient Applicant Signature Page
Designated Caregiver Applicant Signature Page
Minor Patient Applicant Signature Page
Out-of-State Visiting Patient Applicant Signature Page
Request for Administrative Hearing
Applicants for medical cannabis cards, who have received a denial for their card, may request an administrative hearing regarding their denied application.
Please note that you may reapply for a medical cannabis card at your convenience. If you reapply, you must submit the correct signed and notarized signature page with your application. The required signature page for an in-state qualified patient (adult or minor), out-of-state visiting patient, or designated caregiver are available above. Also please be sure that you have received a written certification from a medical cannabis practitioner within 60 days of application submission.
If you choose to appeal the denial of your card application, please use the form here.
Once the form is complete, please email the form and a copy of any written notice and/or documentation that you received relating to this appeal to kymedcancards@ky.gov.
Any hearing resulting from this request shall be conducted in accordance with KRS Chapter 13B.