Get a Card

Find Out If You Qualify

We understand the difficulties involved with determining patient eligibility which is why we have made it easy for New Hampshire residents! Read through the checklists below to determine if you qualify as a patient.

Do you have at least one of the following conditions? (Click to Open)

One or more injuries that significantly interferes with daily activities

Moderate to severe chronic pain

Acquired immune deficiency syndrome (AIDS)


Alzheimer's disease


Chronic pancreatitis

Crohn's disease



Hepatitis C, currently receiving antiviral treatment


Multiple sclerosis

Muscular dystrophy

Parkinson's disease

Positive status for HIV

*Post traumatic stress disorder (PTSD)

Spinal cord injury/disease

Traumatic brain injury

Ulcerative colitis

If yes, please review symptoms.


Do you have at least one of the following symptoms? (Click to Open)

Severe pain for which other treatment options produced serious side effects

Severe pain not responding to previously prescribed medications or surgical procedures

Elevated intraocular pressure


Chemotherapy-induced anorexia

Wasting syndrome

Constant or severe nausea

Moderate to severe vomiting


Severe, persistent muscle spasms

Agitation of Alzheimer's

If yes, please continue below.

Great! Here’s How You Can Register

Step 1

Speak with your physician or Advanced Practice Registered Nurse about therapeutic cannabis.

If your physician agrees, have them fill out the physician form.

You can view the forms to apply to the program here. Effective June 10, 2016, physicians and Advanced Practice Registered Nurses licensed in the states of ME, MA, and VT are permitted under NH state law [RSA 126-X:I, VII(a)(3)] to issue a “Written Certification for the Therapeutic Use of Cannabis” to their patients who are residents of New Hampshire.

Step 2

Access the government-issued application forms at the DHHS website.

You can access the application forms here, or you can view the complete list of state forms and information about the Therapeutic Cannabis Program here.

Review all patient instructions.

Complete the application and submit the following:

Written certification completed by provider

Upload proof of NH residency

Enclose $50 check to Treasurer, State of New Hampshire

Mail or hand-deliver application to:

  • New Hampshire Department of Health and Human Services
  • Therapeutic Cannabis Program
  • 29 Hazen Drive
  • Concord, NH, 03301