Non-Resident Oregon Medical Marijuana ApplicationFill out the application below to see if you qualify!

1Apply Below

Complete the application below, you will then be directed to a medical records release form, this important step will allow us to start working on your application.

2Physician Review

Once your deposit is made and your appointment set, your records will go into an advanced review with our physician to determine your eligibility.

3Get Your Card

Attend your scheduled appointment for the completion of your state application, then simply mail the application to the state and your card will be mailed to you.
Secure Application *Encrypted*
First Name:
Last Name:
Phone:
Email:
Address:
City:
Zipcode:
Birthday: (MM/DD/YYYY)
Step 1 - Basic Qualifications
Are you 18 or older?
If not 18, you must have a parents signiture on the final application. If you have your parents permission, click "yes" to this questions to submit.
Marijuana related felony within 5 years?
The OMMP may not grant you a medical marijuana card if you have been convicted of manufacturing or distributing marijuana within 5 years.
Do you have a valid government issued ID?
Sorry you must have a valid ID
Step 2 - Qualifiying Medical Conditions
***Only choose conditions that have been diagnosed by your MD with corresponding medical records (REQUIRED)***
Severe Pain  
Nausea  
Muscle spasms  
Please list your exact diagnosis and current treatment:
Multi. Sclerosis  
Cachexia  
Cancer  
Glaucoma  
HIV+/AIDS  
Seizures  
Epilepsy  
Alzheimer's  
Migraines  
Fibromyalgia  
Disc Disease  
IBS  
Crohns 
PTSD  
Arthritis  
On your worst day what is your pain level from scale from 1 to 10?
1 = No pain & 10 = Extreme pain
Step 3 - Medical Records
Visited an MD to discuss your symptoms within 1 year?
Do you have at least 2 documented MD visits stating your condition?
Do you have copies of these medical records with you?
Are you currently prescribed any medications for your condition?
sample ommp card
Step 4 - Doctor Recommendation
Schedule an appointment to get your doctors recommendation at our marijuana clinic.
Which clinic location is most convenient for you?
Would you like to receive more information regarding any of the following resources?
Cannabis Dispensaries  
Cannabis Delivery Services  
Finding a grower  
Becoming a grower for other patients 
Volunteering at the OMMC Clinic 



We will contact you with you're results & for scheduling. Thank you!