Healthcare Practitioner Frequently Asked Questions

According to RCW 69.51A.030 the patient must have a new or existing documented relationship with a primary care provider or specialist relating to the diagnosis and ongoing treatment or monitoring of the patient's terminal or debilitating qualifying condition. When providing a medical cannabis authorization:

• Review the professional practice standards established by the regulating Boards and Commissions:
  • Medical Cannabis Authorization Guidelines (PDF)
  • Medical Cannabis Authorization Guidelines (Washington Medical Commission)
• Complete the current Medical Cannabis Authorization Form. Older versions of the form are acceptable until you run out of pre-preprinted, tamper-resistant paper for an older version.
  • Medical Cannabis Authorization Form (PDF) (for practitioner use only)
  • Form instructions (PDF)

No registration or additional certifications are required. Some things to consider include the following:

• Healthcare practitioners must adhere to the same standards of care as when recommending any other controlled substance.
• The patient must have a new or existing documented relationship with a primary care provider or specialist relating to the diagnosis and ongoing treatment or monitoring of the patient's terminal or debilitating qualifying condition - per RCW 69.51A.030.
• RCW 69.51A.010 requires that most qualifying conditions must be unrelieved by standard treatments or medications.
• Follow the professional practice standards for practitioners to consider when issuing an authorizing their patient to use cannabis for medical purposes.
• A healthcare practitioner issuing authorizations for the medical use of cannabis should complete a minimum of three hours of continuing education relating to medical cannabis.
• The following types of healthcare practitioners licensed in Washington State are allowed to authorize the use of cannabis to medical patients:
  • Medical doctor (MD) licensed under chapter 18.71 RCWOsteopathic physician (DO) licensed under chapter 18.57 RCW
  • Osteopathic physician assistant (DOA) licensed under chapter 18.57A RCW
  • Naturopathic physician licensed under chapter 18.36A RCW
  • Advanced registered nurse practitioner (ARNP) licensed under chapter 18.79 RCW

The healthcare practitioner is responsible for completing and signing the Medical Cannabis Authorization form, including whether the patient is eligible to receive a compassionate care renewal under RCW 69.51A.030(2)(c)(iv). Compassionate care means the patient can renewal their recognition card without being present at the cannabis retailer if doing so would likely result in severe hardship to the patient.

The authorization form must be printed on tamper-resistant paper containing the RCW 69.51A.030 logo in the bottom right corner. Tamper-resistant prescription paper with the Pharmacy Quality Assurance Commission seal is not allowed and may prevent the patient from being registered in the Medical Cannabis Authorization Database. 

You can ask your current paper vendor if they are publishing Washington State Medical Cannabis Authorization Tamper-resistant paper. If they are not, contact alternate paper vendors to provide this for you.

No. According to RCW 69.51A.060 nothing in the law requires any healthcare professional to authorize the medical use of cannabis for a patient.

Under RCW 69.51A.030(2) (c)(i) For a qualifying patient eighteen years of age or older, an authorization expires one year after its issuance. For a qualifying patient less than eighteen years of age, an authorization expires six months after its issuance. These dates are determined by the practitioner on the completed form.

A healthcare practitioner will keep a copy of the authorization in the patient's medical record and issue the original to the patient for safe keeping. With a medical cannabis authorization:

• a patient or their designated provider may grow up to four plants within their domicile.
• an adult patient (age 18 and older) may register in the Medical Cannabis Authorization Database (database)
• a minor patient and their designated provider (parent/legal guardian) are required to register in the database
• If registered into the database, a patient (or designated provider) may grow up to six plants, or additional plants if authorized by their healthcare practitioner.

To register, the patient schedules an appointment with a medical cannabis consultant at a medically-endorsed cannabis retail store. For more information, see the Medical Cannabis Authorization Form Guidelines (PDF).

The patient will schedule an appointment with a certified medical cannabis consultant at a licensed and medically endorsed retail cannabis store (PDF).

• The patient must take their medical cannabis authorization form and state-issued identification with them to the appointment.
• The consultant is certified by the Department of Health to assist the patient with the registration process and can create and issue a medical cannabis recognition card.
• The medically-endorsed retail store is required to collect a $1 fee from cardholders when their card is created.

The patient must schedule a renewal appointment with their healthcare practitioner. An authorization may be renewed upon completion of an in-person physical examination or a remote physical examination of the patient if the health care professional determines that requiring the qualifying patient to attend an exam in person would likely result in severe hardship because of the qualifying patient's physical or emotional condition.

Effective July 28, 2019, House Bill 1094 established compassionate care renewals. Under this act, if the healthcare determines requiring an in-person examination to renew an authorization would result in severe hardship to the patient because of their medical condition, the healthcare practitioner may renew the authorization via telemedicine and indicate eligibility on the patient's Medical Cannabis Authorization Form.

Following the initial in-person physical examination to authorize the use of cannabis for medical purposes, the health care professional may determine and note in the patient's medical record and Medical Cannabis Authorization Form that subsequent physical examinations for the purposes of renewing an authorization may occur through the use of telemedicine technology.

A compassionate care renewal of a qualifying patient's registration and recognition card allows the qualifying patient to receive renewals without the need to be physically present at a retailer and without the requirement to have a photograph taken. Instead, the patient's designated provider may renew the patient's registration and recognition card on their behalf.

A compassionate care renewal patient must have a designated provider and have been previously registered in the Medical Cannabis Authorization Database to renew database registration and recognition card.

Adult patients (age 18 and older) who have a DP must sign per RCW 69.51A.010. Minor patients and their DP (parent/legal guardian) are not required to sign. Healthcare practitioners who issue a renewed authorization through the use of telemedicine under this act, will need to request the patient to sign their authorization in the appropriate place upon receipt. Review the Medical Cannabis Authorization Form Guidelines for more details.

State law establishes immunity against prosecution for healthcare practitioners (practitioner) appropriately authorizing the use of cannabis to qualifying patients. However, a practitioner may be charged with unprofessional conduct for not complying with the requirements of Chapter 69.51A RCW. Failure to adhere to state law requirements exposes the practitioner to risk of prosecution under state law and may also result in disciplinary action by the licensing authority. Practitioners might also incur other penalties from privileging hospitals, medical malpractice insurers or certification boards.

Note: It is important practitioners understand that immunity is not extended to federal prosecution as cannabis continues to remain illegal under federal law for any reason.