Medical preferential loading

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

Our Medical Preferential Load Program provides an exemption from the standard “first-come, first-served” policy when a customer has a medical condition that an extended wait on the dock would cause detrimental risks to their health.

To qualify and enroll for preferential loading, customers must work with their health care provider to submit an application certifying the customer can travel without undue health risks but that waiting at the terminal would cause undue health risks.

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.
  • Is approved for preferential loading in one standard-sized (under 22 feet in length) vehicle. Customers authorized for preferential loading in vehicles larger than 22 feet in length are not exempt from the “first-come, first-served” policy due to space allocation on the vessel. This includes recreational vehicles and vehicles with tows.

Need for preferential loading:

  • Must be certified online with a medical preferential loading application, submitted by a licensed health care provider (MDs, RNs, PAs, midwives and affiliated positions) or their designated clinic administrator. 
  • Cannot be certified by physical therapists, chiropractors, etc.

To receive medical preferential loading at the terminal, a customer will need:

  • A printed confirmation email verifying the health care provider has submitted an application on the customer’s behalf to enroll in the program, authorizing preferential loading.
  • An ID matching the name on the printed confirmation email.

To certify a customer qualifies for medical preferential loading, applications to enroll in the program can only be accessed and submitted by your licensed health care provider at:

Please review our Medical Preferential Load Program Rules and Regulations (PDF 196KB) with your health care provider for complete details on this program.

If you encounter any issues, please call customer service at 206-464-6400 or 888-808-7977 or email program administrators at

Arrival times for approved medical preferential loading

For 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 20 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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