If your placard has been lost, stolen, or destroyed, you can submit a new application online here. Have your physician's office email handy so they can help you fill out the form.

Prefer to print and mail the form? Click here.

Fill out the applicant (patient) information, sign, and mail or deliver the form to the address at the bottom of the application, along with an indication that your previous placard had been lost, stolen, or destroyed.

We will issue a replacement placard with the same expiration as the original placard. The original will be cancelled and no longer valid. Please note there is a maximum replacement limit of one (1) placard for lost, stolen, or destroyed placards. Remember: all placards reported as lost or stolen are cancelled and no longer valid.