Licensing and Regulatory Affairs
You must complete the Change Name or Address Form. The form includes instructions and lists the supporting documentation you must submit with the form. The form can be found on our website at www.michigan.gov/mmp.
It is your responsibility to notify your patient(s) that your address has changed. The MMMP will issue your patient(s) a new registry identification card with your updated address.
Change Name or Address Form fee:
$10 (the $10 fee covers all changes requested and all updated registry cards)