Patient Guide

Everything you need to become a medical cannabis patient in Washington State, in plain language. Jump to any section:

Step 0 — Do I qualify?

To be a qualifying patient you must be a Washington resident diagnosed with a terminal or debilitating medical condition — one severe enough to significantly interfere with daily living. Washington’s qualifying conditions are:

Cancer, HIV, multiple sclerosis, epilepsy or other seizure disorders, or spasticity disorders
Intractable pain (pain unrelieved by standard medical treatments and medications)
Glaucoma (acute or chronic) unrelieved by standard treatments
Crohn’s disease with debilitating symptoms unrelieved by standard treatments
Hepatitis C with debilitating nausea or intractable pain unrelieved by standard treatments
Diseases (including anorexia) causing nausea, vomiting, wasting, appetite loss, cramping, seizures, muscle spasms, or spasticity unrelieved by standard treatments
Post-traumatic stress disorder (PTSD)
Traumatic brain injury (TBI)

Source: Washington State Department of Health and RCW 69.51A.010.

Step 1 — Get your authorization

Schedule an appointment with a healthcare practitioner who can authorize medical cannabis. Any of these provider types can sign your authorization:

Medical doctor (MD)
Osteopathic physician (DO)
Naturopathic physician (ND)
Physician assistant (PA)
Advanced registered nurse practitioner (ARNP)

Start with the provider who regularly treats your condition — they know your history best. If they’re unwilling or unable to authorize, you can see another provider; our provider directory lists cannabis-knowledgeable practitioners across the state. Bring your medical records to the appointment.

What it costs

An initial evaluation typically runs $200–$300; renewals often cost less. If you qualify, your practitioner completes the DOH Medical Cannabis Authorization Form (PDF) printed on tamper-resistant paper. It’s valid for up to one year.

Step 2 — Turn your authorization into a recognition card

With your signed authorization, call a medically endorsed cannabis store and book an appointment with their certified medical cannabis consultant — the only people who can enter you into the DOH Medical Cannabis Registry and issue your card. Bring:

Your original authorization form
Government or state-issued photo ID
Card fee (the law sets a $1 minimum; stores may charge more)

Joining the registry is optional — but the benefits below only come with the card. Your first card must be issued in person at an endorsed store.

Why get the card? Registered vs. authorization-only

Benefit	With recognition card	Authorization only
Sales tax on DOH-compliant products	Exempt	You pay it
37% cannabis excise tax on DOH-compliant products	Exempt at endorsed stores	You pay it
Purchase amounts	3× the recreational limit	Recreational limits only
Home growing	6 plants (up to 15 if authorized by your practitioner)	4 plants maximum
Arrest protection	Yes	No — affirmative defense only
Designated provider can buy/grow for you	Yes	Limited

The tax savings are significant

Cannabis in Washington carries a 37% excise tax plus local sales tax. A cardholder buying DOH-compliant products at an endorsed store pays neither — roughly 45% off the shelf price compared to a recreational buyer.

Purchase and growing limits

Product type	Recognition card holder	Recreational / no card
Usable cannabis (flower)	3 ounces	1 ounce
Cannabis-infused solids (edibles)	48 ounces	16 ounces
Cannabis-infused liquids	216 ounces	72 ounces
Concentrates	21 grams	7 grams

Growing at home

Cardholders: 6 plants and up to 8 oz of usable cannabis from them. Your practitioner can authorize up to 15 plants (with up to 16 oz) if medically needed. Tip: hang a copy of your authorization in the garden.
Authorization only (not registered): 4 plants and up to 6 oz — even if your form says more.
No more than 15 plants per housing unit, regardless of how many patients live there (except registered cooperatives, where up to 4 patients may grow together, max 60 plants).

Designated providers (caregivers)

A designated provider (DP) is someone you name to purchase or grow cannabis on your behalf — helpful if illness or mobility makes store visits difficult. Your DP must:

Be 21 or older and named on your authorization form
Get their own authorization form and be entered in the registry with their own recognition card
Serve only one patient at a time
Never consume the cannabis obtained for you or give it to anyone else

To change your DP, remove the current one through your Medical Cannabis Registry account, then get new authorization forms for yourself and your new DP.

Patients under 18

A practitioner may authorize cannabis for a patient of any age when medically appropriate. Minor patients must be entered in the registry and must have a designated provider who is their parent or legal guardian (21+), holds their own card, and makes all purchases.

Ryan’s Law — cannabis in hospitals and hospice (new for 2026)

Effective June 11, 2026, qualifying patients with a terminal condition have the right to access and use their medical cannabis during care at Washington hospitals, nursing homes, and hospice care centers. Facilities have until January 1, 2027 to adopt policies. Key points:

Smoking and vaping are not permitted — other forms (tinctures, edibles, capsules, topicals) are
You’ll need to provide a copy of your authorization, and your use goes in your medical record
You or your designated provider handle acquiring, storing (locked container), administering, and removing the cannabis — staff cannot administer it
Doesn’t apply to emergency departments or patients not admitted for inpatient care

Read our full Ryan’s Law explainer

Renewing each year

Both your authorization and your card expire after one year, so plan to renew both before they lapse. Two newer options can make renewal easier:

Telemedicine renewals: after your first in-person visit, your practitioner may note in your record that you can renew your authorization via telemedicine.
Compassionate care renewal: if renewing in person would cause severe hardship, your practitioner can authorize your designated provider to pick up your renewal card at an endorsed store on your behalf.