Becoming a South Dakota Medical Cannabis Patient — Step-by-Step

Last verified: May 2026

Eligibility Requirements

• South Dakota residency. Required documentation: SD driver’s license, U.S. passport with SD address, or tribal ID. Out-of-state IDs are not accepted for SD-resident applications.
• Age 18+ for adult registration. Patients under 18 require custodial-parent consent and a designated caregiver under SDCL § 34-20G-33.
• Qualifying-condition diagnosis from one of the conditions or symptom-based categories under SDCL § 34-20G-1(8). See qualifying conditions page.
• Bona fide practitioner-patient relationship. The certifying practitioner must have responsibility for the qualifying condition or have received a referral from a treating practitioner who does.

Step 1 — Find an Approved Certifying Practitioner

SD certifying practitioners are physicians (MD, DO), physician assistants (PA), and advanced practice registered nurses (APRN) licensed in South Dakota. As of April 2026, the SDDOH listed 219 approved practitioners statewide. Concentrations are highest in Sioux Falls, Rapid City, and Pierre. See practitioner certification page.

Step 2 — In-Person Certification Visit (NO Telehealth)

The certification visit must be conducted in person. SD law specifically requires an in-person physical examination — telehealth certifications are not permitted, and renewal certifications must also be done in person. The visit covers:

• Review of medical history and current diagnosis.
• Confirmation of a qualifying condition or qualifying symptom.
• Documentation of conventional-treatment-failure showing where applicable.
• Discussion of cannabis pharmacology, drug interactions, and contraindications.
• Recommended starting dosage and product form.
• Issuance of the certification document.

Visit fees range from $100 to $300 depending on the practice. Most practitioners do not accept insurance for the certification visit; some do.

Step 3 — Register with SDDOH

After certification, the patient registers through the SDDOH portal at medcannabisapplication.sd.gov. Required documents:

• SD driver’s license, U.S. passport with SD address, or tribal ID.
• Passport-style photo.
• Practitioner certification (uploaded by the certifying practitioner).

Fees:

• Annual registration fee: $75 ($20 low-income with proof).
• Home cultivation add-on: $20.
• Additional caregiver add-on: $20 per caregiver.

Cards are valid 1 year. Renewal applications must be submitted no later than 45 days before expiration.

Step 4 — Designate a Caregiver (For Minors or Disabled Adults)

Patients under 18 require a designated caregiver who must be the custodial parent or guardian (per SDCL § 34-20G-33). Adult patients with disabilities may also designate a caregiver. Caregivers must:

• Be at least 21.
• Have no disqualifying felony.
• Be designated by the patient on the SDDOH registration.

A caregiver may serve up to five qualifying patients (with an exception for healthcare-facility staff). The caregiver receives a separate caregiver card and can purchase on the patient’s behalf at any licensed dispensary.

Step 5 — Visit a Licensed Dispensary

With the SD medical cannabis card in hand, the patient may visit any SD-licensed dispensary. The 14-day rolling 3 oz cap is tracked at the point of sale by Metrc seed-to-sale software. Cash or debit only (no credit cards due to federal banking restrictions). 4.5% state sales tax + up to 2% local. See first-visit walkthrough.

Step 6 — Annual Renewal

The medical-cannabis card is valid for 1 year. Renewal requires:

• An in-person renewal certification visit with the certifying practitioner.
• SDDOH renewal application.
• Renewal fee.

Renewal applications must be submitted no later than 45 days before card expiration.

Practical Notes

• Plan transportation for in-person visits. SD telehealth is not permitted. Some patients drive 1–2 hours each way.
• Bring complete medical records. Prior treatment documentation makes the qualifying-condition showing easier.
• Renew at least 45 days before expiration. Late renewals can produce gaps in coverage that expose patients to non-cardholder enforcement.
• The card does not protect employment. SDCL § 34-20G-24 expressly preserves employer drug-free workplace policies.