Here you will find a variety of patient forms that can be opened then printed by clicking on each link.

New Patient Forms

-Intro to Practice

-Patient Registration

-Health History

-General Info

-Liability Waiver

-Permission to Share Info

-HIPAA Acknowledgement

-Financial Policy

Records Releases and Requests

Here are our record release / request


NH Therapeutic Cannabis

Below are the NH Therapeutic Cannabis applications. All patients applying for certification will need the top form and the rest of the forms are required only if you plan to have a caregiver buying / dispensing for you because you are unable.

-TC Patient Application

-TC Caregiver Application

-Caregiver Attestation Form

-TC Criminal Records Form for Care Givers