In order to obtain medical marijuana in the State of California, a patient must possess a document known as a Letter of Recommendation, or a Doctor's Recommendation. This document must be provided by a licensed physician, either an M.D. or D.O., stating the patient qualifies for use of cannabis (marijuana) to relieve their medical ailments and the patient must be a documented California resident.



It's important to note that the document in question is NOT a “prescription." Prescriptions are written to denote a specific medicine, dosage amount and frequency of use. Because the cannabis plant has still yet to be federally tested and regulated thoroughly by the Federal Drug Administration (FDA), doctors can only “recommend" its use for patients who seek it as an alternative and/or complimentary medicine.


People unfamiliar with the process of becoming a legal patient in California often incorrectly refer to getting a Doctor's Recommendation as getting a “card." Many other states do require that patients not only have a Doctor's Recommendation but also obtain an ID card through their state Health Departments in order to become legal cannabis patients. Although it offers the same medical marijuana ID card program, California does not require its medical marijuana patients to register with any state organization or agency, and therefore does not require them to carry a “card." California only requires a Doctor's Recommendation in order for a patient to legally possess, grow and use medical marijuana.

The California medical marijuana ID card (MMJ ID) can be obtained through the California Department of Health Services (DHS). A patient must first have a Doctor's Recommendation and then he/she can fill out a form through their local county health department; this allows the patient and doctor to be vetted by the State. Obtaining a state-issued card offers no further validation to a Doctor's Recommendation; it only reduces complications when dealing with law enforcement. This may be very helpful for a patient growing or transporting large amounts of cannabis in any form.

Having a state-issued card allows a patient to be electronically identified and verified by an officer onsite. Possessing only a Doctor's Recommendation is sufficient for a patient to be totally legal and may be completely honored by any law enforcement officer or agency. However, if a particular officer has doubts or is unwilling for whatever reasons to accept a patient's Letter Of Recommendation or contact the patient's physician, having the MMJ ID card and being registered with the DHS may help a patient prevent receiving a ticket and a court appearance to verify his/her Doctor's Recommendation.


As mentioned above, medical marijuana patients with a valid Doctor's Recommendation are not required by the State of California to register with any city, county or state authority. Many first-time patients are concerned that when they obtain their Doctor's Recommendation they are going to become part of a “list" that is monitored by government agencies. This is simply not true. In California, the knowledge of your cannabis use is only between you and your doctor and, if applicable, your medical cannabis provider and “primary caregiver". Your information is private, confidential, and protected by federal HIPAA laws.


California does not offer reciprocity when it comes to Doctor Recommendations. This simply means that collectives in California will NOT accept Recommendations from other states and California Doctor Recommendations will not be valid or accepted by collectives outside the state lines of California. Currently, Colorado and the state of Washington are the only areas where patients can walk into a business an obtain marijuana recreationally (without a Recommendation).


Oftentimes, the patient in need of cannabis medicine is a minor, invalid or someone who requires the services of a Caregiver. If this is the case, the patient will still need to be seen by a licensed M.D. or D.O., provide identification and proof of California residency and be issued a valid Doctor's Recommendation. A second document must then be provided by that same physician, or by the patient's attorney, naming a Caregiver for the patient. California law requires that the person selected must be either the patient's guardian or “primary" medical Caregiver. This document then gives the Caregiver the legal authority to obtain, transport and administer the patient's cannabis medicine.


In order for a first-time patient to receive a Doctor's Recommendation, they must provide a picture ID and proof of California residency. For most, a driver's license will be sufficient. However, if the patient is currently a California resident but doesn't have a state-issued California ID or driver's license yet, he or she can show proof of residency with a document such as a copy of a lease agreement or proof of registration from a California DMV.

Along with the ID and proof of residency, potential patients will need to communicate to the doctor their symptoms and illnesses. The patient must then be physically examined by the actual licensed physician signing and issuing the recommendation. Most Doctor Recommendations are issued for one year at a time but some are given for shorter periods at the doctor's discretion. Regardless, all California Doctor Recommendations have an expiration date, and it's the responsibility of the patient to make sure it's renewed before it expires, to continue legal possession and use of cannabis.