Check-Off List for Qualifying Patients/Caregivers
- Go to https://njmmp.nj.gov/and open Patient Registration page
- Complete required information (as noted by the red asterisk)
- Enter patient reference number supplied by physician and submit
- Complete required patient information (as noted by the red asterisk)
- Enter the Alternative Treatment Center of choice
- 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)
- Upload patient and caregiver photograph - Required
Photograph must be a recent digital photo taken against a white background; the patient/caregiver shall not wear a hat, glasses or any other item that may alter or disguise the overall features of the face; the patient/caregiver face must take up 70 percent of the picture; and a digital photograph must be in JPEG format, which is the format currently used by most digital cameras.
- Document 1 - Government issue photo identification - Required one of the following:
- Current NJ digital license
- Current NJ digital non-driver ID card
- NJ County ID Card
- Document 2 - Proof of current New Jersey residency - Required (P.O. Boxes NOT Accepted) one of the following:
- Utility bill issued in the past 90 days that shows your name at your current address
- Utility Bills accepted: Gas-Electric-Water-Sewer-Cell Phone-Cable (Television/Internet/Phone)
- Any correspondence from IRS or NJ State tax office within the last year.
- Document 3 – Proof of government assistance - Optional one of the following:
- NJ Medicaid
- Food Stamp Benefits
- NJ Temporary Disability Insurance benefits
- Supplemental Security Income (SSI) benefit
- Social Security Disability (SSD) benefits
- 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 for finalizing your application. Approved applicants will be instructed on the MMP e-payment process.
- 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.
Denied applicants will be provided instructions on amending your application.
Questions regarding this process will be addressed by contacting the MMP Customer Service Unit at 609-292-0424 or firstname.lastname@example.org