The District’s Department of Health finally released patient application forms for medical marijuana on Tuesday—the last hurdle for patients seeking the substance. Now, medical marijuana dispensaries could be open and operating as early as next week, says Rabbi Jeffrey Kahn.

It’s been a long and frustrating journey for Kahn, who founded medical marijuana dispensary the Takoma Wellness Center in April 2011. He’s been renting the property ever since, he says, at a significant financial burden. He’s devoted his full-time attention to establishing the dispensary but has yet to treat any patients.

“Nothing else needs to be done,” says Kahn in a phone call. “It’s been long. We’ve been patient. We’re delighted we’re near the end.”

The forms allow patients to register for a medical marijuana license with a doctor’s recommendation and a fee of $100. The sum might seem high but is pretty standard among the 17 states that also permit medical marijuana use. In Nevada, New Jersey, and Oregon, the cards actually cost $200. In D.C., qualifying patients or caregivers whose income is equal to or less than 200 percent of the federal poverty level—or $22,980 per year—will only have to pay $25.00 to register. Due to federal laws, insurance does not cover the cards—or the marijuana.

“[Medical marijuana] is a separate medical option for patients to pursue,” says Scott Morgan, communications director at Capital City Care, the first licensed medical marijuana dispensary in the District and the only dispensary licensed to grow cannabis. “It’s just not covered by insurance. It doesn’t yet fit into the established infrastructure in that way. That’s something that could change.”

“The city is in the process of developing a sliding scale program that will make medicine available to low-income patients,” adds Morgan. “The dispensaries themselves will be funding [this].

Their top priority, however, is getting the program started. Capital City Care’s dispensaries are stocked and ready to go.

“Every day that a patient is waiting for this is a day that a patient might feel a little better,” says Morgan. “We want to get the program running.”

All licensed physicians in the District are qualified to recommend marijuana, but not all are willing. Of around 9,500 physicians that practice medicine in D.C., Kahn estimates only around 18 or 20 have submitted applications for permission to recommend the practice.

Still, the application forms represent a positive step toward operating medical marijuana dispensaries. The District famously legalized medical marijuana in a 1998 vote, but regulatory delays and restrictions have stymied implementation for 15 years. After Congress finally lifted its barriers to legal pot in 2009, D.C. introduced strict policies that limited access to medical marijuana to patients with cancer, HIV/AIDs, glaucoma, persistent muscle spasms, or other conditions treated with chemotherapy, AZT, protease inhibitors, or radiotherapy. Compared to California—whose laws permit marijuana for migraines—our policies are draconian.

Then again, D.C. lies at the doorstep of the Department of Justice, which has been cracking down on California’s medical dispensaries in the past month. Perhaps the stringent regulations will prevent similar lawsuits from coming to the District—provided the dispensaries start operating.

“I can’t tell you what the federal government will do,” says Morgan. “I can say is that in the past federal enforcement efforts have focused on situations that are very different from D.C. In D.C., we have a strictly regulated program with rules created by local government. The program is designed to protect patients with serious illness who truly benefit from this medicine.”

The dispensaries, and the local government, aren’t taking any chances. They’re adhering to the strict regulations—with hopes that the District government will loosen them in the future.

“It would be unbelievably disrespectful to the people of D.C. if the federal government stepped in now,” says Kahn, noting the amount of taxpayer money and effort which has gone into opening these dispensaries. “We’re all ready.”