Medical preferential loading

Learn about our medical preferential loading policy, which provides riders with medical conditions an exemption from the standard “first-come, first-served” policy.

Our medical preferential loading provides an exemption from the standard “first-come, first-served” policy when a rider has a medical condition that an extended wait on the dock would cause detrimental risks to their health

This program is not for use to get to appointments on time when waiting at a terminal would not cause any health risks. You are responsible for planning for any extended waits in such cases.

When sailings are on overload and there are long wait times at the terminal, a customer with medical preferential status:

  • Sails on the next available scheduled sailing
  • Is not entitled to first-on, first-off positioning

Need for preferential loading:

  • Must be certified by a physician on a Medical Preferential Load Program Attending Physician/Hospital/Clinic Form faxed directly to the terminal
  • Can only be certified by doctors, nurses, midwives and affiliated positions (RN, PA, etc.)
  • Cannot be certified by physical therapists, chiropractors, etc.

Applications for medical preferential loading can be requested by calling us at 1-888-808-7977 or 206-464-6400 and can be sent to the physician via email, fax or mail. Applications will be sent only to a physician, hospital or clinic. We never send applications directly to the patient/customer.

The Medical Preferential Load Program Rules and Regulations (PDF 218KB) document has complete details on this program.

Arrival times for approved medical preferential loading

For our Anacortes/San Juan Islands route:

  • Customers are required to arrive 30 minutes before sailing time.
  • Customers who arrive before the vessel has departed but after the gate is closed will not be able to board.

For all other routes:

  • Customers are required to arrive at least 15 minutes before sailing time.
  • We cannot guarantee boarding for late arrivals.
  • We will try to load late arrivals if space and time permits. However, we cannot hold vessels or delay sailings for late arrivals.

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as recorded by WSDOT and partners in 2020 and 2021.

46% increase in Amtrak Cascades ridership to 251,000 passengers

in 2021 compared to 172,000 in 2020.

Nine wetland and stream mitigation sites across 32.7 acres added

to our monitoring program in 2021 to help offset climate change impacts.