It was really frustrating since we painstakingly followed the instructions to the letter and ran into a myriad of issues. Took a couple months with a lot of follow up and perseverance. Tried email and phone calls. The phone approach is the only thing that worked but it was common to be on hold for over an hour and many times after holding for more than an hour the line just went dead. Here's the issues (NOTE: We weren't contacted in any way about what the issues were even though we provided a phone number and an email address in the initial form). The check for the $75 fee was cashed well over a month before we got it all straightened out): - Supply a passport level photo. Got them professionally done at Walgreen and included two in the info package/form we sent in. Supplying a photo in the mailed in application was the required approach. Months went by and the web site continued to say no photo provided. When we finally got through on the phone we were told the photos were coming out blurred so we needed to use one of the new methods for supplying a photo. No way it was the photos we supplied. Had to have been a glitch with their scanner or whatever they were using. I finally uploaded one through the web site after using photo software to get a picture down to the 192 x 192 pixels required. - The name of our town had been changed a few years ago and they compared it to the driver license. Since the license had the old town name we were told we had to change the name of the town using the web site so it agreed to the driver's license. There have been NEW processes added that may mitigate the above going forward: - The passport quality photo issue may be resolved by a new direction. Here's the description "The Registry is now connected to the Division of Highway Safety and Motor Vehicle’s State ID system. If there is a match to the information supplied by your Physician your State ID or Driver’s License photo is automatically added to your online application". To be honest....there's something worrisome about connecting the certification to the driver's license. Assuming this connection is bi-directional it could become an instantaneous heads-up to the police when you're driving that you are also a MJ user.