New York State Cannabis Research License Application
Thank you for your interest in conducting cannabis research in New York State. Under the requirements of section 38 of the Cannabis
Law, the Office of Cannabis Management (the Office) developed Part 132, the Cannabis Research License regulations. The Office is
now accepting applications for researchers to become cannabis research licensees. To ensure your application is reviewed in a timely
manner, please review all submission requirements before beginning your application.
A PDF version of the application is available to review here: NYS Cannabis Research License Application
General Application Information
1. An application fee of $250.00 is required along with the completion of this form. Applicants that are approved for a Cannabis Research
License must submit a license fee of $500.00 within ten (10) business days of the notification of approval in order to receive the
license.
All fees are non-refundable and must be a certified check. Do not send cash or a credit card number. Please include applicant name and
date of application submission on the memo line on your certified check. All required fees must be mailed directly to:
New York State Office of Cannabis Management
Attention of: Licensing - Research
PO Box 2071
Albany, NY 12220
2. Upon receipt of the application and application fee, an administrative member of the Office will conduct a preliminary review of the
application and notify the applicant of any deficiencies or concerns using the e-mail address provided at the start of this
application. Applications will not be reviewed unless the application fee is received by the Office.
3. At any time during the review of an application prior to approval or denial, the applicant may withdraw the application. Withdrawal of
an application is without prejudice to re-filing the application. If an applicant wishes to resubmit an application at a future time, a new
application will need to be submitted to the Office with the non-refundable application fee.
4. All applications will be assessed for completion, accuracy, and proof of adequate credentials.
5. The Board will approve or deny a research application after the application review is completed.
6. Applicants will be contacted by e-mail to notify them of approval or denial of the application. Upon notification, applicants will have ten
(10) business days to submit their license fee of $500.
7. Freedom of Information Law (“FOIL”): The Office’s records are subject to disclosure under the Freedom of Information Law. Trade
secrets or confidential information that would cause substantial injury to the competitive position of a business are exempt from
disclosure under the Freedom of Information Law. To claim this exemption, an applicant must submit a written request to the Office and
identify the specific information they are seeking to protect from disclosure. After receipt of this request, the Office will make a
determination as to whether to withhold the information from disclosure. If the Office denies the exemption request, the applicant has the
right to appeal this determination. (See Public Officers Law Section 89(5)).
If you have any questions regarding your application, please email research@ocm.ny.gov.
Applicant Information
Applicant Name:
Please note that the applicant must be the individual serving as the principal investigator (PI) of the project(s).
First: * MI: Last: *
E-Mail Address: *
(###) ###-####
Phone Number: *
Mailing Address: *
City: * State: * Zip Code: *
Other
Name/Alias:
Date of Birth: *
Applicants must be 21 years of age or
older.
� MM/DD/YYYY
(E.g.:
http://www.example.com)
Business Website
URL:
Citizenship
No Yes
Representation
No Yes
Are you a citizen or lawful permanent resident of the United States? *
Are you being represented by an attorney or other representative? *
Existing Registration, Permit or License
No Yes
Name of Attorney or Representative *
First Name: * Last Name: *
E-mail Address: *
(###) ###-####
Phone Number: *
Business Address: *
City: * State: * Zip Code: *
Do you currently hold an existing license, permit, or registration with the Office of Cannabis Management (i.e.,
Testing Laboratory, Cultivator, Processor, Registered Organization, etc.)? *
Research Site Information
Entity Information: *
Entity
Name:
License Type:
License
Number:
Please describe the research activities to be conducted that do not fall within the scope of the activities authorized
under your current cannabis license, permit, or registration (i.e., activities not authorized by the current cannabis
license, activities exceed canopy size, etc.): *
No Yes
Provide the intended research site name and location where the proposed study will be performed, including GPS
coordinates. This address cannot be a PO BOX or place of residence.
Site Name: *
Site Address: * GPS Coordinates (Latitude and Longitude): *
City: *
NY
State: * Zip Code: *
Site Mailing Address (If different from Site
Address)
City:
NY
State: Zip Code:
Do you have an additional research site to submit? *
Additional Research Site Information
How many additional research sites do you need to submit? *
Provide information about the additional intended research site where the proposed study will be performed. The
site address cannot be a PO BOX or place of residence.
Site Name: *
Site Address: * GPS Coordinates (Latitude and Longitude): *
City: *
NY
State: * Zip Code: *
Site Mailing Address (If different from Site
Address)
City:
NY
State: Zip Code:
Affiliated Organization Attestation
Proposed Research Project Information
If working within an organization, an attestation of support from the affiliated organization is required to be
submitted along with this application. This attestation is not required if:
The PI is also the owner, president, or chief executive officer of the organization; or
The research is not taking place on the organization’s property.
NYS Cannabis Research License Application Organization Attestation
Label PDF attachment: "PI Last Name_Organization Attestation”
(e.g., Doe_Organization Attestation)
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How many research projects are being proposed? *
Research Type (Select all that apply): *
Animal
Human Observational
Clinical
Agricultural
Genomic
Lab-based (chemical
potency/composition)
Other - Write In (Required)
*
Intended Operating Activities (Select all that apply): *
Outdoor cultivation
Indoor cultivation
Mixed light cultivation
Drying/curing
Laboratory testing
Processing
Waste rendering
Dispensing of investigational
products (IP) to research subjects
Administration of investigational
products (IP) to research subjects
Other - Write In (Required)
*
Attach a description of the proposed research to be conducted. Please ensure the requested information is
provided in a clear, concise, and accurate manner to facilitate the timely review of the Cannabis Research License
application.
If multiple research projects are being proposed in this application, please provide the following information in a
separate document for each research project:
Project Title
Abstract (400 words or less): A brief description of the purpose, methods, and anticipated outcomes of the
proposed research projects.
Research Project Narrative: A description, including study design, of the research to be conducted (maximum
3 pages). PDFs of relevant publications or articles authored by the applicant or key personnel may be included
as supplemental information.
Key Personnel: A list of all key personnel and their roles. Key personnel include but are not limited to co-
principal investigator(s), sub-investigator(s), licensed physician(s), research staff, and any other individuals
who will contribute to the scientific development or execution of the project in a substantive way. A curriculum
vitae (CV) or resume of all key personnel must be provided.
Investigational Product(s) (IP): A description of investigational products to be used in the study including
any cannabis, cannabis-derived products, or cannabis-related products. The applicant may acquire
investigational products by sale or donation from other licensees, permittees, or registrants of the Board. If
the amount needed for the project will exceed the personal possession limits of 3 ounces of cannabis and 24
grams of concentrated cannabis, a formal contract or agreement is required in accordance with the contract
and agreements section of this application. The IP description must include the following information:
Type of investigational products (i.e., whole flower, ground plant products, cannabis concentrate,
cannabis placebo, etc.) to be used for the research project.
Amount or quantity anticipated to be needed over the duration of the research project, including
justification for the amount to be grown or purchased by the applicant.
Source including the licensed entity’s name, license number, address, and, if available, the date of sale to
the applicant.
If cannabis is proposed to be cultivated, propagated, or harvested, provide a site plan and the
proposed canopy size for the cultivation space (e.g., square footage, indoor/outdoor, etc.). Provide
information detailing how the canopy size or purchased cannabis products are consistent with the
project scope and goals.
Funding: A description of any existing or anticipated funding sources for the research project. Plans for how
the applicant intends to obtain funding to support the proposed research project are also acceptable. Plans
should include specific grants or funding opportunities the applicant plans to apply for.
Disposal: A plan for the disposal or donation of investigational product waste generated from the research
project.
Location: Provide the location(s) the research project will be performed.
*
Using the following the format, label PDF attachment sequentially for each project document being submitted:
"PI Last Name_Project #_Description”
(e.g., Doe_Project 1_Description)
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Upload any approvals, conditional approvals, or continuing review documents that have been received by the
IACUC for the research project(s).
*
Using the following format, label PDF attachment sequentially for each project document being submitted: "PI
Last Name_Project #_IACUC”
(e.g., Doe_Project 1_IACUC)
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Contracts and Agreements
Storage and Security Plan
Upload any approvals, conditional approvals, exemptions, or continuing review documents that have been received
by the Institutional Review Board (IRB) for the research project(s). The following information must also be provided:
Description of all proposed human subjects, including but not limited to demographic information and details on
those deemed “vulnerable” participants (children, prisoners, pregnant women, mentally disabled persons); and
A copy of the approved Assent and/or Informed Consent Form(s).
*
Using the following format, label PDF attachment sequentially for each project document being submitted: "PI
Last Name_Project #_IRB”
(e.g., Doe_Project 1_IRB)
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Provide a copy of any contracts and agreements between the applicant and any research partners, vendors, or
contractors. This includes individuals or entities licensed, permitted, or registered with the Board involved in any
aspect of the research project(s). Letters of intent will be accepted to fulfill this requirement.
Using the following format, label PDF attachment sequentially for each project document being submitted: "PI
Last Name_Project #_[Contract Name]”
(e.g., Doe_Project 1_[Contract Name])
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Reporting Requirements
Initials:
Provide a security plan for how investigational products (IP) will be safeguarded against diversion, theft, or loss,
including any security measures for storing all investigational products the licensee will have in their possession.
This plan should include a list of any key personnel who will have access to the investigational products. Failure to
provide a sufficient security plan may result in application denial.
Using the following format, label PDF attachment sequentially for each project document being submitted: "PI
Last Name_Project #_Storage”
(e.g., Doe_Project 1_Storage)
Browse...
I attest that I will maintain and make available to the Office, upon request, the following documentation:
Inventory tracking records, including any cultivated, produced, purchased or donated investigational product
(IP);
IP dispensing logs, if applicable;
IP disposal records;
List of research subjects; and
Adverse events that occur during study participation.
*
Initials:
I attest that I will submit the following:
Annual report(s) to the Board;
IRB determinations, including amendments and continuing reviews (within 10 business days of
receipt);
Substantial changes to the research project(s);
Copies of any publications about the research project(s); and
A synopsis of the research project(s) at study closure.
*
Initials:
Record Retention
Initials:
Attestation
I attest that I will notify the Office in a timely manner of the following incidents:
Serious adverse events that occur during trial participation (within 24 hours of PI awareness);
Inventory discrepancies;
Diversion, theft, loss or unauthorized destruction of IP;
Loss or unauthorized alteration of IP or human subject records;
Any event or incident that is reported to duly authorized law enforcement by way of a signed statement (within
24 hours of discovery of the event); or
Discovery of the following (within 1 business day):
Alarm activation (not including planned or accidental activations) or event that requires public safety
personnel;
Security breaches; and
Security alarm system failures lasting longer than 8 hours.
Notification should be sent by email to research@ocm.ny.gov. *
I attest that I am aware I must maintain copies of all documents and correspondence sent to or from the Office for
at least seven (7) years.
*
Thank You!
Thank you for submitting your application. A copy of your completed application will be emailed to you.
By signing below, I attest that all information included on this application, and all documentation accompanied
therein, is true, complete, and accurate. I am aware that any false statements, inaccuracies, or omitted information
may be grounds for denial of a NYS Cannabis Research License.
*
Signature of
Sign name using mouse or touch pad
Clear
