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Get Nh Dhhs Application For The Therapeutic Use Of Cannabis Qualifying Patient 2021-2025
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How to fill out the NH DHHS Application For The Therapeutic Use Of Cannabis Qualifying Patient online
This guide provides step-by-step instructions for filling out the NH DHHS Application For The Therapeutic Use Of Cannabis Qualifying Patient online. It aims to assist users in navigating the application process clearly and effectively.
Follow the steps to complete your application successfully.
- Click ‘Get Form’ button to obtain the form and open it for editing.
- Enter your personal information in the Patient Information section, including your name, address, birth date, phone number, and email address if desired. Ensure accuracy while typing.
- Indicate whether this is an Initial Application or Renewal Application by selecting the appropriate option.
- In the Medical Provider Information section, fill in the details of the medical provider who completed the Written Certification for you, including their name, business address, and phone number.
- Complete the Medical Information Release by signing and dating it to authorize your provider to release relevant medical information to the NH Department of Health and Human Services.
- Select one Alternative Treatment Center (ATC) from the list provided, making sure to check only one box.
- If applicable, provide information for a Designated Caregiver. This section is optional unless you are applying for a minor.
- If the applicant is a minor, have the custodial parent or legal guardian complete the requirements outlined, including their initials for consent.
- Review all entries for accuracy and completeness before proceeding.
- Once all sections are complete, save the form. You may then download, print, or share the completed application for submission.
Complete your NH DHHS Application For The Therapeutic Use Of Cannabis Qualifying Patient online today!
Out-of-state patients with a valid medical cannabis card from another state are allowed to bring their cannabis into New Hampshire and use it in the state. They must also have documentation from their physicians that they have a condition that qualifies under New Hampshire law.
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