Terminal Conditions and Florida Medical Marijuana Rules
Yes. Florida lists a terminal condition as its own qualifying category at § 381.986(2)(l), but it must be diagnosed by a physician other than the one issuing the certification. The law defines terminal narrowly, and the first certification visit must still be an in-person exam.
What does Florida law say about terminal conditions?
Paragraph (l) of § 381.986(2) lists "A terminal condition diagnosed by a physician other than the qualified physician issuing the physician certification." The full list reads:
Florida law lists: cancer; epilepsy; glaucoma; positive HIV status; AIDS; post-traumatic stress disorder (PTSD); ALS; Crohn's disease; Parkinson's disease; multiple sclerosis; conditions of the same kind or class as or comparable to those; a terminal condition diagnosed by a physician other than the certifying physician; and chronic nonmalignant pain.
How does the statute define a terminal condition?
Section 381.986(1)(p) defines it as "a progressive disease or medical or surgical condition that causes significant functional impairment, is not considered by a treating physician to be reversible without the administration of life-sustaining procedures, and will result in death within 1 year after diagnosis if the condition runs its normal course."
How is this category different from the others?
For most qualifying conditions, the certifying physician makes the diagnosis, with your records as support. A terminal condition is the exception.
The law requires the terminal diagnosis to come from a separate physician, usually the one managing your care, such as an oncologist, specialist or hospice physician.
What rules are different for terminal conditions?
- The terminal diagnosis must come from a different physician than the one who certifies you (§ 381.986(2)(l)).
- When a physician certifies smoking as a route for most patients, extra documentation must be sent to the state medical board. Section 381.986(4)(c) exempts patients with a terminal condition from that requirement.
- Smokable marijuana cannot be certified for a patient under 18 unless the patient has a terminal condition, the physician finds smoking the most effective route, and a second physician who is a board-certified pediatrician agrees, with the parent or guardian's written informed consent.
What records should I bring?
- A letter or visit notes from your treating physician that state the terminal diagnosis
- Records of the underlying illness, such as oncology, cardiology, pulmonary or neurology notes
- Hospice or palliative care admission records, if you are enrolled
- A complete list of current medicines
Is the first visit still in person?
Yes. Before an initial certification, the physician must do an in-person physical exam, meaning the physician is physically in the same room as the patient. There is no exception for terminal conditions. If travel is hard, ask about timing when you book, and plan for a family member or caregiver to come with you.
For later visits: Telehealth is allowed only for renewals: a physician who already certified the patient after an in-person physical exam may do that patient's later exams and re-evaluations by telehealth.
Can a family member handle purchases?
Yes, once they are registered as your caregiver. A caregiver must be a Florida resident age 21 or older, agree in writing to help, complete a state caregiver course (renewed every two years), pass a background screening unless a close relative of the patient, hold a caregiver ID card, and generally assist only one patient. A caregiver cannot be a qualified physician or have ties to a dispensary, and may not be paid beyond actual expenses.
Common questions.
Can your physician diagnose my terminal condition?
No. Florida law requires the terminal diagnosis to come from a physician other than the one issuing the certification. Our physician reviews that diagnosis and completes the rest of the evaluation.
Does a hospice enrollment count as proof?
Hospice records are strong supporting documents. The physician still needs records showing a terminal diagnosis from another physician that meets the statute's definition.
Can the first visit be done at home or by video?
Florida law requires the initial exam to be in person, with the physician in the same room as the patient. Later re-evaluations with the same physician can be by telehealth.
Is my underlying illness also a qualifying condition?
It may be. Cancer, ALS and several other conditions are listed on their own. The physician will note which qualifying condition or conditions apply.
What if my records don't say the condition is terminal?
The statute's definition includes that the condition will result in death within 1 year after diagnosis if it runs its normal course. If your records don't meet that definition, the physician will look at whether another qualifying condition applies.
Bring your treating physician's records
Book an in-person evaluation at our Temple Terrace office, and tell us about any travel limits when you call.
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