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Application form: variation to medicinal cannabis licence (type 3) – change to layout of site, floorplan, authorised activities, add authorised person/s.

Use this form to apply for a type 3 variation to a medicinal cannabis licence under the Narcotic Drugs Act 1967.  You can apply to make changes to the layout of a site or the floorplan of a licensed premises (although conditions apply). Also, you can apply to authorised activities and/or add authorised person/s to the licence.

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Application forms

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

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