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)

Acquired immune deficiency syndrome


Alzheimer's disease


Amyotrophic lateral sclerosis


Cancer


Chronic pancreatitis


Crohn’s disease


Ehlers-Danlos syndrome


Epilepsy


Glaucoma


Hepatitis C


Lupus


Multiple sclerosis


Muscular dystrophy


One or more injuries or conditions that has resulted in one or more qualifying symptoms listed below


Parkinson's disease


Positive status for human immunodeficiency virus


Spinal cord injury/disease


Traumatic brain injury


Ulcerative colitis


If yes, please review symptoms.

Or do you have at least one of the following stand alone conditions? (Click to Open)

Moderate to severe post-traumatic stress disorder


Moderate to severe chronic pain


Severe pain that has not responded to previously prescribed medication or surgical measures or for which other treatment options produced serious side effects


If yes, please continue below.

AND

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

Agitation of Alzheimer’s disease



Chemotherapy-induced anorexia


Constant or severe nausea



Moderate to severe vomiting


Constant or severe nausea


Seizures


Severe pain that has not responded to previously prescribed medication or surgical measures or for which treatment options produced serious side effects


Severe, persistent muscle spasms


Wasting syndrome


If yes, please continue below.

Great! Here’s How You Can Register

Step 1

Speak with your physician or other accepted provider about therapeutic cannabis:

A NH physician licensed to prescribe drugs to humans under RSA 329


A NH advanced practice registered nurse (APRN) licensed to prescribe drugs to humans under RSA 326-B:18


A NH physician assistant licensed pursuant to RSA 328-D, who has the express consent of the supervising physician


A physician or APRN licensed to prescribe drugs to humans under state licensing laws in Maine, Massachusetts, or Vermont, and who is primarily responsible for the patient's care related to their qualifying medical condition

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

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