Registered Patient Application Form: New patients must complete this form to register. Patients renewing their registry card must also complete this form annually. There is a $50 fee to register or to renew. To become a registered patient, a person must be diagnosed with a debilitating medical condition by a health care professional in the course of a bona fide health care professional-patient relationship. A registered patient must be a resident of Vermont. “Resident of Vermont” means a person whose domicile is Vermont.

Download the VMR Registered Patient Application Form