Last verified: April 2026
Where the Program Lives
The Therapeutic Cannabis Program (TCP) is operated by the New Hampshire Department of Health and Human Services (NHDHHS) at 29 Hazen Drive, Concord, NH 03301. The patient registry is authorized under RSA 126-X:4; administrative rules sit at He-C 401 and He-C 402, with the most recent rule updates effective October 1, 2025. Program email is tcp@dhhs.nh.gov; the program phone line is (603) 271-9931.
The Six-Step Application Path
Most New Hampshire applicants follow the same path from first appointment to first dispensary visit:
- Find a certifying healthcare provider. Under SB 357 (2024), certifying providers include physicians (MD/DO), advanced practice registered nurses (APRN), physician assistants (PA), dentists, podiatrists, optometrists, and naturopathic doctors with prescriptive authority. Many patients use telehealth platforms or established primary-care providers; some ATCs maintain provider referral lists. See qualifying conditions.
- Get a written certification. The provider documents your qualifying condition under RSA 126-X:1, IX or, after HB 1278 (effective October 1, 2024), any debilitating or terminal condition for adults 21+ where benefits likely outweigh risks. The provider also documents the SB 357 counseling for patients under 25 and women of childbearing age.
- Assemble the application packet. The packet includes the NHDHHS application form, your provider certification, a copy of a New Hampshire-issued photo ID (driver’s license or state ID), and the $50 fee. Caregiver applications carry their own $50 fee and require a separate background check.
- Submit by mail or in person. NHDHHS requires applications to be received by mail or hand-delivered to 29 Hazen Drive. Telemedicine-only certification is not permitted; the provider must establish the relationship through at least one in-person visit under RSA 126-X:1, VIII.
- Wait approximately 21 days. NHDHHS targets a 21-day processing window for complete applications. Incomplete packets or background-check holds extend the timeline.
- Receive your card and visit an ATC. The registry ID card arrives by mail. Once received, you can purchase from any of the ATCs around the state — no walk-ins, registry card and matching photo ID required at the door. See the ATCs.
NHDHHS targets a 21-day processing window for complete TCP applications. Card validity was historically one year, but May 2023 rule changes allow providers to issue certifications valid up to three years for established patients — a meaningful reduction in renewal friction for patients with stable chronic conditions.
RSA 126-X:4 — Patient registry; New Hampshire DHHS rule updates (May 2023)
Fees, Card Validity, and Renewals
| Item | Cost / Term |
|---|---|
| New patient registration | $50/year |
| Patient renewal | $50/year |
| Caregiver registration | $50 (no fee for renewals) |
| Replacement card (lost/stolen) | $25 |
| Initial card validity | 1 year |
| Established-patient certification | Up to 3 years (provider discretion, May 2023 rule) |
| Processing time (typical) | ~21 days |
| Telemedicine certification | Not permitted (must be at least one in-person visit) |
Designated Caregivers
RSA 126-X allows a qualifying patient to designate a caregiver who may obtain cannabis from an ATC on the patient’s behalf and may possess cannabis under the patient’s 2-ounce cap. Caregivers must register separately with NHDHHS, pass a criminal background check, and pay the $50 caregiver fee. Caregivers may serve more than one patient subject to NHDHHS approval. Designating a caregiver is the standard path for pediatric patients, bedridden patients, and patients without reliable transportation to an ATC.
Patient Growth — A Decade of Slow Then Fast
The first patient ID card was issued in late 2015 only after attorney Paul Twomey successfully sued NHDHHS to compel issuance to terminally ill cancer patient Linda Horan. The first ATCs opened in April 2016. From 2,089 patients in 2016, the program has grown to roughly 15,000 to 17,000 active patients as of late 2025. The Marijuana Policy Project placed the late-2025 total near 17,000; news outlets in early 2026 have cited “around 15,000.” Either figure is six to eight times the 2016 baseline.
Out-of-State Patients
Visiting patients with valid out-of-state medical cannabis credentials do not need to apply for an NH card to use NH ATCs. Under HB 1278 (effective October 1, 2024), a visiting patient may purchase from any NH ATC subject to the same 2 oz / 10-day cap that applies to in-state patients, by presenting an out-of-state medical cannabis ID and a matching photo ID. NH does not require reciprocal patients to share a qualifying NH condition. See products & rules for the reciprocity details.
Common Application Pitfalls
- Telehealth-only certifications. NH does not accept these. The provider relationship must be established with at least one in-person visit under RSA 126-X:1, VIII.
- Photo ID mismatch. The application photo ID must match the address and name on the certification form. Recent name changes need supporting documentation.
- Missing SB 357 counseling note. For patients under 25 or women of childbearing age, the provider must document risk counseling. Some applications are returned because this note is absent from the certification packet.
- Out-of-state addresses. NH cards are for NH residents; visitors should not apply for an NH card and should instead use HB 1278 reciprocity with their home-state credentials.
Explore the TCP
Official Sources
- NHDHHS Therapeutic Cannabis Program
- RSA 126-X — Therapeutic Use of Cannabis
- NHDHHS TCP — tcp@dhhs.nh.gov / (603) 271-9931
For in-depth cannabis education, dosing guides, safety information, and research summaries, visit our partner site TryCannabis.org