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:
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 with corresponding medical records. NOTE: If you are currently pregnant or breastfeeding, please wait to complete an application until you are not.

Severe Pain  
Muscle spasms  

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

Multi. Sclerosis  

Please list your EXACT diagnosis and current treatments:
Step 4 - Medical Records
Have you been diagnosis by a medical professional?
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!