Get the free NH PRESCRIPTION DRUG - nh

NH PRESCRIPTION DRUG MONITORING PROGRAM 121 South Fruit Street Concord, NH 03301 Phone: (603) 2716980 Fax: (603) 2712856 Office of Professional Licensure and Certification NH Board of Pharmacy REQUEST

How to fill out nh prescription drug

How to fill out nh prescription drug

1. Find the prescription drug form available on the NH government website.
2. Provide personal information such as your name, address, and contact details.
3. Include your NH Medicaid ID or proof of eligibility for NH Prescription Assistance, if applicable.
4. Specify the prescription drug details, including the name, strength, and dosage.
5. Attach a valid prescription from a licensed healthcare provider.
6. Ensure the prescription is within the allowed refill period, if applicable.
7. Submit the completed form along with any required supporting documents.
8. Wait for the NH Prescription Drug Program to review and approve your application.
9. If approved, you will receive your prescription drug benefits.
10. Follow any additional instructions provided by the NH Prescription Drug Program, such as copayment requirements or preferred vendors.

Who needs nh prescription drug?

1. New Hampshire residents who require prescription medications.
2. Individuals who are eligible for NH Medicaid and need assistance with prescription drug costs.
3. People with low income who meet the eligibility criteria set by the NH Prescription Drug Program.
4. Patients with specific medical conditions that require ongoing medication.
5. Elderly individuals who rely on prescription medications for their health and well-being.
6. Anyone who wants to access affordable prescription drugs through the NH Prescription Drug Program.

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