New Patient Qualifications

• You MUST be a resident with a qualifying condition as described below, and have proof, of Washington State. Which is defined as law as a current and valid Washington state drivers license or picture ID. There is no membership fee.
• You will need to print out 2 forms from our web site: Membership form and the Authorization Form. Fill out the Membership form and take it with you to your next doctor's appointment. Provide the Authorization form to your physician to sign.
• After your doctor signs the Authorization form please request the nurse or office staff to fax both the Authorization form and Membership form including a fax cover sheet with their letter head to our fax number located at the bottom of our home page.
• Once we receive the forms our Intake Coordinator verifies the signature with your doctor's office and then will contact you to schedule and orientation.

To qualify for protection by the statute, the patient must be diagnosed by his/her Washington-licensed physician as having a “terminal or debilitating medical condition.” The statute defines terminal or debilitating medical condition as:

(a)    Cancer, human immunodeficiency virus (HIV), multiple sclerosis, epilepsy or other seizure disorder, or spasticity disorders; or
(b)    Intractable pain, limited for the purpose of this chapter to mean pain unrelieved by standard medical treatments and medications; or
(c)    Glaucoma, either acute or chronic, limited for the purpose of this chapter to mean increased intraocular pressure unrelieved by standard treatments and medications; or
(d)    Any other medical condition duly approved by the Washington state medical quality assurance board [commission] as directed in this chapter.

RCW 69.51A.010(4)(a-d). The Washington State Medical Quality Assurance Commission has since added the following to the list of approved conditions:

• Crohn’s disease with debilitating symptoms unrelieved by standard treatments or medications (November 5, 1999 Final Order)
• Hepatitis C with debilitating nausea and/or intractable pain unrelieved by standard treatments or medications (January 28, 2000 Final Order)
• Any disease, including anorexia, which results in nausea, vomiting, wasting, appetite loss, cramping, seizures, muscle spasms, and/or spasticity, when these symptoms are unrelieved by standard treatments or medications. (June 19, 2000 Final Order)

Be sure to note RCW 69.51A.010(4)(b) (“intractable pain, limited for the purpose of this chapter to mean pain unrelieved by standard medical treatments and medications”). This functions as a catch-all and provides a defense to patients whose conditions are not on the approved list, provided they can show that standard treatments and medications have failed them.

One last note: if your client is successfully using marijuana to treat a condition not listed above, please encourage him/her to contact us, as speaking with such patients gives us a better idea of what conditions we might petition the Medical Quality Assurance Commission to add to the list.

 

Membership Form

The Membership Application is for you, the patient, to fill out and remember to fax this form together with your authorization form that your physician signs for you. Without this we will have no way to contact you when it is verified.

Authorization Form

The Washington State Medical Association has updated its medical marijuana authorization form to bring it current with the amendments enacted by Senate Bill No. 6032.The new form can be downloaded here: http://www.wsma.org/memresources/Med_Mari_authorization.pdf

The authorization form is to be signed only by your physician.

Patients who already possess medical authorization under the previous version of the form do not need to update their authorization to be in compliance with the Washington State Medical Use of Marijuana Act. Those forms will remain valid. However, if you are a patient whose physician filled in an expiration date on their authorization form, you are advised to renew with the updated authorization form upon the date of it's expiration. Once all needed forms have been completed and signed by the patient, they will then need to be faxed together to our office for verification and processing. Please be advised that the verification process may take up to 3 business days. Your patients and cooperation is greatly appreciated.