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Application form: variation to a medicinal cannabis licence (type 1) – change name of licence holder, change names and/or descriptions of authorised persons, remove persons

Use this form to apply for a type 1 variation to a medicinal cannabis licence under the Narcotic Drugs Act 1967. You can apply to vary the name of the licence holder, vary the name and description of authorised persons specified on the licence, or remove authorised persons from the licence.

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Tips for completing form

When completing this application form keep in mind:

  • you can choose to fill out the application form in Word or PDF (see under 'downloads' heading below)
  • a relevant signature is required on the application form 
  • once completed, please email this application form along with all relevant supporting documentation to the ODC at mcs.application@health.gov.au.

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Apply for a type 1 variation to a medicinal cannabis licence -change name of licence holder, change names and/or descriptions of authorised persons, remove persons
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