Online Application Resources

To apply online:

• You must be a patient without a caregiver and create a secure online account.
• Your physician must have an online account.
• Follow the instructions to apply for a Patient Only Registry Card 

To renew online:

• You must be a patient without a caregiver (or willing to remove your caregiver at renewal) and create a secure online account.
• Your physician must have an online account.
• You must follow the instructions to Link to you existing record.
• Follow the instructions to Renew a Patient Only Registry Card

To submit an amendment online:

• You must be a patient and create a secure online account.
• You must follow the instructions to link to your existing record.
• You must follow the instructions to submit an amendment.

   ONLINE INSTRUCTIONS:

• Create a secure online account (patient without caregiver)
• Apply for Patient-Only Registry Card online (patient without caregiver)
• Link to your Existing Record
• Renew Patient Only Registry Card
• Request Replacement Card
• Name and/or Address Change
• Remove Caregiver
• Withdraw from MMMP

 Online Application Portal