Oregon Medical Marijuana Card Application


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.
Step 1 - Contact Information
First Name:
Middle Initial:
Last Name:
Phone:
Birthday: (MM/DD/YYYY)
Email: (Updates will be sent here)
Confirm Email:
Step 2 - 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.
Do you have a valid government issued ID?
Sorry you must have a valid ID
Step 3 - Qualifying Medical Conditions
Only choose conditions that have been FORMALLY diagnosed (based on lab, x-ray, MRI results, ETC.) by your MD or DO with corresponding medical records:

Severe Pain  
Nausea  
Muscle spasms  


Click here for common condtions which may qualify under "Severe Pain", "Severe Nausea", and/or Muscle Spasms

PTSD  
Multi. Sclerosis  
Cachexia  
Cancer  
Glaucoma  
HIV+/AIDS  
Seizures  
Epilepsy  
Alzheimer's  


Please list your EXACT diagnosis and current treatments:
Step 4 - Medical Records
Have you visited an MD to discuss this specific condition within 1 year?
Do you have copies of these medical records in your possession?
Have you been prescribed any medications for your condition?
On your worst day, what is your symptom severity level? 1 = Mild & 10 = Severe:
Step 5 - 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 



By submitting this application, you confirm that all the information you provided is true and accurate. We look forward to working with you and will contact you shortly!