Checklist for Qualifying Patients/Caregivers
- Go to https://njmmp.nj.gov/ and open Patient Registration page.
- Enter all required information on Attending Health Care Practitioner's Statement.
- Complete required patient information (as noted by the red asterisk).
- Enter the Alternative Treatment Center of choice. This can be changed at any time.
- Complete patient certification.
- Complete required caregiver information (if applicable).
- Click “Save and Continue” and review confirmation page.
- Continue to upload documents for both patient and caregiver (if applicable).
- Taken within the last 60 days
- Taken against a plain, white background such as a wall
- No hats permitted
- No glasses permitted
- Full-face view, directly facing the camera with both eyes open and neutral facial expression
- Do not use any photo filters
- Current NJ Driver's License
- Current NJ Non-Drivers ID issued by NJ Motor Vehicle Commission
- NJ County ID showing patient name and address
*Note: If your current government issued photo ID is expired or does not reflect your current physical address, you will have to supply 2 proofs of New Jersey Residency from the list below
3. Proof of New Jersey Residency (Choose one of the following):
- Utility Bill issued within the 90 days preceding the application date
- Gas, electric, water, sewer, landline phone, cell phone, cable, television, internet
- Correspondence from the Internal Revenue Service (IRS) or the New Jersey Division of Taxation, issued within the year preceding the application date, that shows the patient's name and address
- Including but not limited to a 1099 Statement, Form 1098, W-2, etc.
*Note: We do not accept a Form 1040 or Form 1095
- Federal, State, or local government correspondence issued to the applicant within the 90 days preceding the application date, that shows the patient's name and address
- Examples: Social Security Administration (SSA) documents, jury summons or court issued notices, property tax bills
- Bank statements issued within each of the three months preceding the application date, which shows the patient's name and address (this means you must submit 3 statements)
Proof of government assistance (if applicable)
- Save and continue
- If applicable, download the caregiver criminal background check form. The caregiver is required to complete form and follow the attached instructions.
The MMP will review your application and supporting documents. All applications will be responded to via e-mail with further instructions to finalize your application. Approved applicants will be emailed instructions on the MMP e-payment process to pay the card fee.
- Once notified by the MMP of the fee amount, the patient will be prompted to return to the registry homepage and click on payment (you will need your patient reference number). Click submit and complete the required information (as noted by the red asterisk). If submitted correctly, you will receive a transaction confirmation number on the last page.
Payment: The registration fee for the MMP identification card is $100.00. If you qualify under one of the following categories, you are eligible for the reduced fee of $20.00.
Denied applicants will be provided instructions on amending your application via email.
Questions regarding this process will be addressed by contacting the MMP Customer Service Unit at 609-292-0424 or firstname.lastname@example.org