The State of Hawaii has established a program to allow patients with specific medical needs to legally use cannabis for therapeutic purposes. This authorization is granted through the state-issued 329 Registration Card, commonly known as the medical marijuana card. Obtaining this card is a multi-step process that confirms a patient’s medical eligibility and registers them with the Department of Health (DOH). The card serves as the only legal means for qualifying patients to purchase, possess, and cultivate medical cannabis within the state.
Establishing Eligibility and Finding a Certifying Physician
Securing a medical cannabis card requires meeting the state’s medical and residency prerequisites. An applicant must be a resident of Hawaii, providing proof of residency, or a visiting patient who qualifies for a temporary card. The primary requirement is receiving certification from a licensed Hawaii health care provider who confirms the patient has a debilitating medical condition.
The state recognizes several specific qualifying conditions. These include:
- Cancer
- Glaucoma
- Human Immunodeficiency Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS)
- Post-traumatic stress disorder (PTSD)
- Lupus, rheumatoid arthritis, epilepsy, and multiple sclerosis
A patient may also qualify if they suffer from conditions or treatments that produce severe pain, severe nausea, cachexia, severe and persistent muscle spasms, or seizures.
Recent legislative changes grant physicians broader discretion to certify patients if they believe the condition may benefit from medical cannabis, even if it is not explicitly listed. Patients must establish a relationship with a licensed Hawaii physician, Doctor of Osteopathic Medicine (DO), Advanced Practice Registered Nurse (APRN), or Physician Assistant (PA). This provider must be registered with the DOH to issue medical cannabis certifications. Telemedicine appointments are permitted for both initial and renewal certifications, making the process accessible across the islands.
The Online Registration Process
Once a certifying provider has been identified, the patient must initiate the administrative application through the state’s electronic registration system. This process is managed by the Hawaii Department of Health (DOH) via their official online portal, which is the sole method for submitting a new application. The patient must create a personal account and upload necessary identification documents, such as a valid state ID and proof of Hawaii residency.
After the patient completes their portion, the certifying physician or APRN must access the same system to submit their medical certification electronically. This two-part submission is required by the state to ensure that both the patient’s administrative details and the medical professional’s recommendation are properly linked and processed together.
A non-refundable state application fee, currently set at $38.50, must be paid online via credit or debit card when the patient submits their portion. Once the physician submits the certification, the DOH reviews the complete application for compliance. The waiting period for approval is short, with many patients receiving their digital 329 Registration Card within one to two business days.
Understanding Patient Responsibilities and Card Usage
Receiving the 329 Registration Card grants specific rights but also imposes limitations on possession and use. Registered patients are permitted to possess up to four ounces of usable cannabis, including manufactured products, at any given time. A patient, or their designated caregiver, is allowed to cultivate up to ten cannabis plants. These plants must be tagged with the patient’s registration number and grown in a secure location declared on the application.
Purchases of medical cannabis must be made exclusively at one of the state’s licensed retail dispensaries. Dispensaries cap sales at no more than four ounces every fifteen days to ensure patients do not exceed the legal possession limit. The use of medical cannabis is strictly limited to private property and is prohibited in all public places, including beaches, parks, and places of employment.
The card is not a permanent authorization and requires annual renewal to remain valid. The renewal process mirrors the initial application, requiring the patient to see a licensed physician or APRN for re-certification and to pay the recurring application fee. A key limitation for patients in Hawaii is the prohibition of transporting cannabis or any manufactured product between islands.