Recommending Cannabis in Washington

Health care professionals recommending medical cannabis must be licensed to practice medicine in the State of Washington. Physicians, physician’s assistants, naturopaths and advanced registered nurse practitioners have the authority to recommend medical cannabis for the treatment of a wide variety of terminal and debilitating conditions. A physical condition must be conducted as appropriate and recommendations must be issued on tamper-resistant paper.  There are no state registration requirements for health care professionals or their patients. Below is an overview of state requirements for recommending clinicians and links to other helpful information.


  • Cancer
  • Multiple Sclerosis
  • Human Immunodeficiency Virus (HIV)
  • Epilepsy or other seizure disorder
  • Spasticity disorders
  • Intractable pain, unrelieved by standard treatments
  • Glaucoma, unrelieved by standard treatments
  • Crohn’s disease, unrelieved by standard treatments
  • Hepatitis C, unrelieved by standard treatments
  • Diseases, including anorexia, which cause nausea, vomiting, appetite loss, cramping, seizures, muscle spasms or spasticity
  • Any other condition approved by Washington’s Medical Quality Assurance Commission in consultation with the Board of Osteopathic Medicine and Surgery


  • Must be licensed to practice medicine in the State of Washington
  • Must have a documented relationship with patient (newly initiated or existing)
  • Must complete a physical exam, as appropriate based on age and condition
  • Must document terminal or debilitating condition in patient’s medical record and that patient may benefit from the use of medical cannabis for noted condition
  • Must inform patient of other options to treat medical condition
  • Must document other attempted measures to treat patient’s medical condition that do not involve the use of cannabis
  • Must not receive financial compensation of any sort from dispensaries, producers or processors of medical cannabis
  • Must not offer a discount or other item of value to patients who agree to become customers of a specific dispensary, producer or processor
  • Must not examine or offer to examine patients at any location where medical cannabis is produced, processed or dispensed
  • Must not have a business which consists solely to authorize the use of medical cannabis 
  • Must not include any references to medical cannabis in business advertisements
  • Must not hold an economic interest in an enterprise that dispenses, produces or processes medical cannabis

More info:

DOH Authorization Practice Guidelines