Patients under the age of 18 are required to have a caregiver apply on their behalf. Patients who are 18 years or older need proof of Pennsylvania residency in the form of a Pennsylvania driver’s license or a Pennsylvania issued state identification card with their current address.
(Your information must be entered exactly as it appears on your driver’s license or non-driver’s ID. For example enter your name in all capital letters if that is how it appears on your ID. If your street is listed as ST, RD, DR, AVE, etc, enter it as the abbreviation do not type out the words ROAD, STREET, DRIVE or AVE. )