The parent or legal guardian of a minor patient (under 18 years old) must submit, in one envelope, a complete MMMP Minor Application Packet, which can be found on our website at www.michigan.gov/mmp.
- A complete Minor Application Form
- Two (2) complete Physician Certification Forms signed by two (2) different physicians (the forms are part of the Application Packet)
- A complete Declaration of Person Responsible Form (the form is part of the Application Packet)
- Proof of parentage or legal guardianship (example: a copy of minor’s government-issued birth certificate)
- Proof of Michigan residency for the minor’s parent or legal guardian, which means one of the following:
- A copy of the parent or legal guardian’s valid, lawfully obtained Michigan driver license issued under the Michigan vehicle code, 1949 PA 300, MCL 257.1 to 257.923, or
- A copy of the parent or legal guardian’s valid, lawfully obtained Michigan personal identification card issued under 1972 PA 222, MCL 28.291 to 28.300, or
- A copy of the parent or legal guardian’s valid Michigan voter registration
- Note: If you submit a voter registration as proof of Michigan residency, you must submit proof of your identity for verification purposes. Proof of identity can be any government-issued document that includes your name and date of birth.
- The $40 required application fee (check or money order made payable to: State of Michigan- MMMP)
