NAC: CHAPTER 678C - REGISTRY IDENTIFICATION CARDS AND LETTERS OF APPROVAL

[Rev. 6/3/2026 1:49:23 PM]

CHAPTER 678C - REGISTRY IDENTIFICATION CARDS AND LETTERS OF APPROVAL

[NAC-678C Revised Date: 4-26]

GENERAL PROVISIONS

678C.010 Definitions.

678C.020 “Chief Medical Officer” defined.

678C.030 “Department” defined.

ISSUANCE, MAINTENANCE AND RENEWAL

678C.100 Application: Required accompanying information.

678C.110 Written notice of approval or denial of application; issuance of card or letter.

678C.120 Notification to Division of change in information.

678C.130 Renewal.

678C.140 Fees.

DESIGNATED PRIMARY CAREGIVERS

678C.150 Restrictions.

PETITION FOR QUALIFICATION OF DISEASE OR CONDITION AS CHRONIC OR DEBILITATING MEDICAL CONDITION

678C.200 Submission; confidentiality; period for approval.

678C.210 Review by Chief Medical Officer; return to petitioner.

678C.220 Determinations by Chief Medical Officer.

678C.230 Notification of approval or denial.

678C.240 Final decision for purposes of judicial review.

MISCELLANEOUS PROVISIONS

678C.300 Tracking and evaluation of attending provider of health care by Division; submission of certain information to appropriate regulatory boards.

GENERAL PROVISIONS

NAC 678C.010 Definitions. (NRS 678C.810, 678C.840) As used in this chapter, unless the context otherwise requires, the words and terms defined in NAC 678C.020 and 678C.030 have the meanings ascribed to them in those sections.

(Added to NAC by Dep’t of Agriculture by R095-01, eff. 10-1-2001; A by Health Div. by R042-03, 9-24-2003; A by Dep’t of Agriculture by R189-03, 1-3-2005; A by Div. of Pub. & Behavioral Health by R004-14, 3-28-2014, eff. 4-1-2014; R148-15, 9-9-2016; A by Dep’t of Taxation by R092-17, 2-27-2018)—(Substituted in revision for NAC 453A.010)

NAC 678C.020 “Chief Medical Officer” defined. (NRS 678C.810) “Chief Medical Officer” means:

1. The Chief Medical Officer appointed pursuant to NRS 439.085; or

2. The designee of the Administrator of the Division, if:

(a) No Chief Medical Officer has been appointed pursuant to NRS 439.085;

(b) The position of Chief Medical Officer appointed pursuant to NRS 439.085 is vacant; or

(Added to NAC by Health Div. by R042-03, eff. 9-24-2003)—(Substituted in revision for NAC 453A.028)

NAC 678C.030 “Department” defined. (NRS 678C.840) “Department” means the Department of Taxation.

(Added to NAC by Dep’t of Agriculture by R095-01, eff. 10-1-2001)—(Substituted in revision for NAC 453A.040)

ISSUANCE, MAINTENANCE AND RENEWAL

NAC 678C.100 Application: Required accompanying information. (NRS 678C.220, 678C.840)

1. In addition to the materials required by NRS 678C.220, an application for a registry identification card or letter of approval must include:

(a) A written statement signed by the applicant’s attending provider of health care verifying that he or she was presented with a photographic identification of the applicant and the designated primary caregiver, if any, or, for an application for a letter of approval, a photographic identification of the designated primary caregiver and, if such identification exists, of the applicant, and that the applicant and the designated primary caregiver, as appropriate, are the persons named in the application;

(b) On forms prescribed by the Division, any information required by the Central Repository for Nevada Records of Criminal History;

(d) A medical cannabis program waiver and liability release form that is prescribed by the Division and signed by the applicant and designated primary caregiver, if any, or, if the application is for a letter of approval, by the designated primary caregiver and, if capable of signing, the applicant;

(e) An acknowledgment form that is prescribed by the Division and signed by the applicant and designated primary caregiver, if any, or, if the application is for a letter of approval, by the designated primary caregiver and, if capable of signing, the applicant;

(f) If the applicant is under 18 years of age, a minor release form signed by the designated primary caregiver of the minor; and

(g) Proof that the applicant is a resident, including, without limitation, a photocopy of a driver’s license issued by the Department of Motor Vehicles or a photocopy of an identification card issued by the Department of Motor Vehicles.

2. The Division will request a name-based check of an applicant, a designated primary caregiver or the parent of a child from the Central Repository for Nevada Records of Criminal History and, if such check is inadequate to determine the criminal history of an applicant, designated primary caregiver or parent of a child, the Division may request a complete set of the fingerprints of the applicant and the designated primary caregiver, if any.

3. As used in this section, “resident” has the meaning ascribed to it in NRS 678C.220.

(Added to NAC by Dep’t of Agriculture by R095-01, eff. 10-1-2001; A by R189-03, 1-3-2005; A by Div. of Pub. & Behavioral Health by R004-14, 3-28-2014, eff. 4-1-2014; R148-15, 9-9-2016)—(Substituted in revision for NAC 453A.100)

NAC 678C.110 Written notice of approval or denial of application; issuance of card or letter. (NRS 678C.840)

1. If the Division approves an application for a registry identification card or letter of approval:

(a) The Division will provide the applicant and designated primary caregiver, if any, with written notice of its approval.

(b) The applicant and designated primary caregiver, if any, must present the written notice and proof of identity to an appropriate office of the Department of Motor Vehicles in order to receive a registry identification card or to the Division in order to receive a letter of approval. Upon the presentation of the written notice and proof of identity:

(1) The Department of Motor Vehicles shall prepare and issue a registry identification card to the applicant and designated primary caregiver, if any, after it has confirmed by telephone or other reliable means that the Division has approved the issuance of the card; and

(2) If applicable, the Division will prepare and issue a letter of approval to the applicant.

2. If the Division denies an application for a registry identification card or letter of approval, the Division will provide the applicant and designated primary caregiver, if any, with written notice of its denial by certified mail.

(Added to NAC by Dep’t of Agriculture by R095-01, eff. 10-1-2001; A by Div. of Pub. & Behavioral Health by R004-14, 3-28-2014, eff. 4-1-2014; R148-15, 9-9-2016)—(Substituted in revision for NAC 453A.110)

NAC 678C.120 Notification to Division of change in information. (NRS 678C.250, 678C.840) A person who is required to comply with the provisions of NRS 678C.250 shall notify the Division of any change in the information required by that section within 7 days after the change in that information.

(Added to NAC by Dep’t of Agriculture by R095-01, eff. 10-1-2001; A by Div. of Pub. & Behavioral Health by R004-14, 3-28-2014, eff. 4-1-2014)—(Substituted in revision for NAC 453A.120)

NAC 678C.130 Renewal. (NRS 678C.230, 678C.810) A person to whom a registry identification card or letter of approval has been issued may renew that card or letter by:

1. Submitting to the Division a form for renewal prescribed by the Division and the materials required by NRS 678C.220 and NAC 678C.100; and

2. Returning the expired registry identification card or letter of approval to the Division.

NAC 678C.140 Fees. (NRS 678C.840) The Division will charge and collect the following fees:

1. For the issuance to a person, for the first time, of a packet of application materials to be used in applying for a registry identification card or letter of approval.....................	$25
2. For the issuance to a person of a registry identification card or letter of approval after the Division has approved the person’s application to receive a registry identification card or letter of approval.....................................................................................................	$75

(Added to NAC by Dep’t of Agriculture by R189-03, eff. 1-3-2005; A by Div. of Pub. & Behavioral Health by R004-14, 3-28-2014, eff. 4-1-2014; R148-15, 9-9-2016)—(Substituted in revision for NAC 453A.140)

DESIGNATED PRIMARY CAREGIVERS

NAC 678C.150 Restrictions. (NRS 678C.840)

1. Except as otherwise provided in subsection 3, a person with a chronic or debilitating disease to whom a registry identification card has been issued may not be a designated primary caregiver.

2. A designated primary caregiver may not be the designated primary caregiver to more than two persons.

3. A person with a chronic or debilitating disease to whom a registry identification card has been issued who is the parent or guardian of a child who has been issued a registry identification card or letter of approval may be the designated primary caregiver for such a child.

(Added to NAC by Dep’t of Agriculture by R095-01, eff. 10-1-2001; A by Div. of Pub. & Behavioral Health by R148-15, 9-9-2016)—(Substituted in revision for NAC 453A.150)

PETITION FOR QUALIFICATION OF DISEASE OR CONDITION AS CHRONIC OR DEBILITATING MEDICAL CONDITION

NAC 678C.200 Submission; confidentiality; period for approval. (NRS 678C.810)

1. A person may submit to the Chief Medical Officer, in the form prescribed by the Division, a petition requesting that a particular disease or condition be included among the diseases and conditions that qualify as chronic or debilitating medical conditions.

2. The contents of a petition submitted pursuant to subsection 1 are confidential and, except as otherwise provided in NAC 678C.230, neither the Chief Medical Officer nor the Division shall disclose the name or other identifying information of:

(a) The person who submitted the petition; or

(b) The attending provider of health care, if any, of the person who submitted the petition.

3. The Division, through the Chief Medical Officer, will approve a petition submitted pursuant to subsection 1 within 180 days after the date on which the petition is received.

(Added to NAC by Health Div. by R042-03, eff. 9-24-2003)—(Substituted in revision for NAC 453A.200)

NAC 678C.210 Review by Chief Medical Officer; return to petitioner. (NRS 678C.810)

1. The Chief Medical Officer will review each petition that is submitted pursuant to subsection 1 of NAC 678C.200 to determine whether:

(a) The petition is in the form prescribed by the Division;

(b) The petition is complete; and

(c) The particular disease or condition described in the petition is already included among the diseases and conditions that qualify as chronic or debilitating medical conditions.

2. If, as determined by the Chief Medical Officer, the petition:

(a) Is not in the form prescribed by the Division;

(b) Is not complete; or

(c) Describes a particular disease or condition that is already included among the diseases and conditions that qualify as chronic or debilitating medical conditions,

Ê the Chief Medical Officer will refuse to accept the petition and will return the petition to the person that submitted the petition, accompanied by an explanation of the reason for its return.

(Added to NAC by Health Div. by R042-03, eff. 9-24-2003)—(Substituted in revision for NAC 453A.210)

NAC 678C.220 Determinations by Chief Medical Officer. (NRS 678C.810)

1. If a petition that is submitted pursuant to subsection 1 of NAC 678C.200 is determined by the Chief Medical Officer to meet the requirements for submittal that are set forth in NAC 678C.210, the Chief Medical Officer will determine whether the Division will include the particular disease or condition that is described in the petition among the diseases and conditions that qualify as chronic or debilitating medical conditions.

2. The determination of the Chief Medical Officer as to whether the Division will include a particular disease or condition among the diseases and conditions that qualify as chronic or debilitating medical conditions must be made in consideration of, without limitation:

(a) The symptoms of the disease or condition;

(b) The expected duration of the symptoms of the disease or condition;

(d) The side effects of the medical treatments available for the disease or condition, including, without limitation, the duration of those side effects; and

(e) The presentation of scientific literature regarding the disease or condition.

(Added to NAC by Health Div. by R042-03, eff. 9-24-2003)—(Substituted in revision for NAC 453A.220)

NAC 678C.230 Notification of approval or denial. (NRS 678C.810) Within 10 working days after the date on which the Chief Medical Officer approves or denies a petition that is submitted pursuant to subsection 1 of NAC 678C.200, the Division will transmit a copy of the approval or denial to:

1. The person who submitted the petition; and

2. The Executive Director of the Department.

(Added to NAC by Health Div. by R042-03, eff. 9-24-2003)—(Substituted in revision for NAC 453A.230)

NAC 678C.240 Final decision for purposes of judicial review. (NRS 678C.810) The decision of the Chief Medical Officer to deny a petition that is submitted pursuant to subsection 1 of NAC 678C.200 is a final decision for the purposes of judicial review.

(Added to NAC by Health Div. by R042-03, eff. 9-24-2003)—(Substituted in revision for NAC 453A.240)

MISCELLANEOUS PROVISIONS

NAC 678C.300 Tracking and evaluation of attending provider of health care by Division; submission of certain information to appropriate regulatory boards. (NRS 678C.220, 678C.840)

1. The Division will register and track each attending provider of health care who advises a patient that the medical use of cannabis may mitigate the symptoms or effects of the patient’s medical condition. To the extent possible, the Division will maintain a confidential record of:

(a) The number of patients whom the physician advises that the medical use of cannabis may mitigate the symptoms or effects of the patients’ medical conditions;

(b) The chronic or debilitating medical conditions of such patients;

(c) The number of times the physician advises each patient that the medical use of cannabis may mitigate the symptoms or effects of the patient’s medical condition;

(d) The number of different chronic or debilitating medical conditions for which the physician advises each patient that the medical use of cannabis may mitigate the symptoms or effects of the patient’s medical conditions; and

(e) How frequently the physician advises each patient that the medical use of cannabis may mitigate the symptoms or effects of the patient’s medical condition.

2. Based on its evaluation of the records maintained pursuant to subsection 1, if the Division determines that an attending provider of health care is advising patients that the medical use of cannabis may mitigate the symptoms or effects of the patients’ medical conditions at a rate that appears unreasonably high, the Division will notify the Board of Medical Examiners or the State Board of Osteopathic Medicine in writing so that the appropriate board may investigate the notification as a complaint against the physician pursuant to chapter 630 or 633 of NRS, as applicable.

3. The Division will, for each calendar year, submit to the Board of Medical Examiners and the State Board of Osteopathic Medicine for each physician licensed by that board the information the Division maintains pursuant to subsection 1.

4. If the Division has reason to believe that the public health, safety or welfare imperatively requires action, the Division may refer, in writing, a case involving an alleged violation by a physician of any provision of this chapter or chapter 678C of NRS related to the medical use of cannabis to the Board of Medical Examiners or the State Board of Osteopathic Medicine so that the appropriate board may investigate the referral as a complaint against the physician pursuant to chapter 630 or 633 of NRS, as applicable.

(Added to NAC by Div. of Pub. & Behavioral Health by R004-14, 3-28-2014, eff. 4-1-2014)—(Substituted in revision for NAC 453A.716)