Frequently Asked Questions

A government-issued photo ID that shows your North Dakota or Minnesota address, and medical records that document your qualifying condition. Please get your records to us before the visit so Dr. Ewals has time to review them. Not sure how to request records? Call and Will can walk you through it.

Alternative Health may offer same-day medical evaluations, in Grand Forks or by telehealth, when appointments are available. A same-day visit doesn't mean same-day state approval: North Dakota usually takes 2 to 4 weeks, and Minnesota usually takes 2 to 4 weeks. Call Will at (218) 274-4500 to check today's openings.

A North Dakota card lasts 2 years. A Minnesota registration lasts 3 years (checked October 2026). Each time it runs out, you need a new certification from Dr. Ewals and a renewal with the state. The official North Dakota and Minnesota program pages have the latest rules.

Each state has its own list. North Dakota names about two dozen conditions, such as cancer, PTSD, epilepsy, migraine and fibromyalgia, plus long-term conditions that cause severe pain, nausea, seizures or muscle spasms. Minnesota lists 19 conditions and lets the certifying provider approve others when cannabis would help (checked October 2026). Send records that show your diagnosis and we'll tell you where you stand.

Yes. The state needs a clinician's written confirmation of a qualifying condition, and Dr. Ewals needs something on paper to base it on: a visit note, a specialist letter or a printout from your patient portal all work. If you have the condition but nothing written down, call us and we'll help you figure out where to get it.

If Dr. Ewals finds you qualify, you finish an online application and the state decides. In North Dakota, you apply on the state's registration site, name Dr. Ewals as your provider and pay a $40 state fee; she then completes your certification online. In Minnesota, she enters your certification first and the state emails you a link to enroll, with no state fee. Once approved, you buy from a licensed dispensary in your state.

Eligibility is set by state law and by clinical judgment. Please tell us ahead of time if you are pregnant or breastfeeding, have a history of psychosis, or don't live in North Dakota or Minnesota. These can affect whether certification is right for you.

Only where that state allows it, so check before you go. North Dakota doesn't accept other states' cards, but visitors who have one can buy a 60-day North Dakota card online for $40. Minnesota lets visiting patients with another state's card buy at its medical dispensaries (checked October 2026). Federal law still doesn't allow carrying cannabis across state lines.

Not while impaired. Driving under the influence is illegal in both states, and being a registered patient is not a defense. Dr. Ewals will talk with you about timing, dosing and forms that make impairment less likely.

Yes, it can. Cannabis use disorder is possible, and the risk is higher with frequent use and high-THC products. Dr. Ewals will talk through risks, side effects, driving and medication interactions with you.

No. We're an independent clinic. We don't sell cannabis, and we don't receive payments from dispensaries or pharmacies.

Yes. Eligible residents can complete their medical evaluation by telehealth, submit their application online, and receive a state decision without a routine trip to the clinic. Additional examination or documentation may be required.

A new-patient evaluation at Alternative Health costs $250. North Dakota charges a separate $40 application fee, for a typical combined initial cost of $290.

Qualifying conditions include anxiety disorders, PTSD, migraines, neuropathy, fibromyalgia, certain chronic pain conditions, and other state-recognized diagnoses. Certification requires an individualized medical evaluation.

Medical documentation helps verify your condition and clinical history. If you don't have records readily available, contact our team before booking to discuss what information is needed.

Your provider may be able to complete the clinical evaluation during your appointment, but certification depends on your medical circumstances and the required state application steps. A same-day visit does not mean same-day state approval.

North Dakota advises allowing two to four weeks after receiving a complete application, payment, and provider certification. Processing may take longer if information is missing.

Generally two years. The state recommends renewing approximately 45 days before your current card expires.

North Dakota also allows the state to independently verify the patient's application, even after a doctor has approved the patient.

According to North Dakota Century Code § 19-24.1-05, the state may verify the information submitted, contact the healthcare provider, and request additional documentation to confirm the patient's medical condition and eligibility.

A patient could be denied if:

• The patient does not meet the state's eligibility requirements.
• Required information or documentation is missing.
• The patient provides false or falsified information or makes a material misstatement.
• The patient's medical condition does not qualify under the program's requirements.
• The patient's healthcare provider does not meet the applicable requirements, or the required bona fide provider-patient relationship does not exist.
• The patient has a previous card revocation that triggers a statutory ground for denial.

North Dakota Health and Human Services specifically identifies false application information, an unqualified medical condition, and the absence of a bona fide provider-patient relationship as potential reasons for recommending denial.

What this means: Even if the application appears complete, North Dakota can deny it if its verification process establishes that the patient does not meet the program's legal requirements.

Official source: North Dakota Century Code chapter 19-24.1

Approved patients may purchase authorized products from North Dakota's registered medical marijuana dispensaries. The state does not extend the same protections to products purchased outside its authorized dispensary system.

Yes. You can have your evaluation by telehealth from anywhere in Minnesota, then enroll with the state online from the link it emails you. Dr. Ewals may ask for more records if needed.

Alternative Health may offer same-day medical evaluations, completely online by telehealth, when appointments are available. The state controls enrollment approval, and that process usually takes 2 to 4 weeks. Call Will at (218) 274-4500 to check today's openings.

A new-patient evaluation at Alternative Health is $250. Minnesota charges patients no fee to enroll or re-enroll, so $250 is the total (checked October 2026). Returning patients Dr. Ewals certified before pay $230.

Minnesota law lists 19 conditions, including chronic pain, PTSD, cancer, seizures, autism, irritable bowel syndrome and obstructive sleep apnea. Your practitioner can also certify another condition when cannabis is recommended (checked October 2026). See the full list.

In three steps, all online after your visit. Dr. Ewals enters your certification in the state registry. The Office of Cannabis Management emails you a personal link, and you finish enrolling. Once the state approves you, you can buy from a Minnesota medical cannabis dispensary.

Aim for 60 days. The state says your certification expires if you aren't enrolled and approved within 90 days, and approval usually takes 2 to 4 weeks. If it expires, you'd need a new certification visit.

Three years from the day you're enrolled (checked October 2026).

Minnesota medical cannabis enrollment must be renewed every 3 years. To avoid a lapse in coverage:

1. 90 days before expiration: Schedule your medical recertification appointment.
2. Within 60 days after recertification: Submit your online renewal application to the Minnesota Office of Cannabis Management.
3. Allow up to 30 days: The state reviews your application and notifies you when approved.

Important: Your renewal must be approved within 90 days of your provider recertification, or you'll need another certification. Start early to avoid an interruption in your medical cannabis enrollment.

No. Minnesota doesn't mail a card. You get a registry number, and dispensaries look up your enrollment in the state registry. Bring a photo ID when you shop.

A short online check-in about your symptoms. Minnesota asks you to complete one before your first purchase, then every 3 months during your first year (checked October 2026). It helps the state track how patients are doing.

Yes, if you're 21 or older. Patients under 21 can't smoke or vape medical cannabis, so they use other forms, such as tinctures, capsules and topicals.

Yes, to enroll. Bring a Minnesota ID or other proof that you live there. Visitors with another state's medical card can buy at Minnesota medical dispensaries but can't enroll. North Dakota residents use North Dakota's program, which Dr. Ewals also certifies for.

Yes. As of October 2026, Minnesota allows eligible visitors with a valid out-of-state medical marijuana card to purchase medical cannabis from participating licensed dispensaries. Bring your valid medical marijuana card and government-issued photo ID. Minnesota medical certification is not required for qualifying visiting patients.

In Minnesota, the state cannot arbitrarily deny an eligible patient's medical cannabis enrollment. Under Minnesota Statutes § 342.52, the state may only deny enrollment for the following reasons:

• The patient fails to submit the required healthcare practitioner certification.
• The patient does not sign a required disclosure.
• The patient fails to provide information required by the state.
• The patient provides false information on the application.
• The patient is enrolled in a federally approved clinical trial for the treatment of a qualifying medical condition with medical cannabis at the time of application.

What this means: If the doctor provides a valid certification, the patient submits all required information accurately, signs the necessary disclosures, and none of the statutory grounds for denial applies, the state should approve the enrollment.

In North Dakota, about 7 weeks before your card expires: state law asks for renewals at least 45 days before the card expires, and renewing early no longer shortens your new card. In Minnesota, about 90 days before your registration expires, so the state can approve it in time. Our renewal countdown works out the dates from your expiry.

$230 if Dr. Ewals certified you before, or $250 if you were certified somewhere else. A $50 deposit holds your appointment, and the rest is due before your visit. The state fee is separate: $40 in North Dakota and nothing in Minnesota (checked October 2026).

You can't buy from a dispensary until you're registered again. The state treats a lapsed card the same as a renewal, so book a recertification with Dr. Ewals and reapply with the state as soon as you notice.

Usually not. We keep your file from your last visit. If your condition, treatment or medicines have changed, send updated records ahead of the visit.

Usually. It focuses on how things have gone since your last certification, what's working and anything that's changed, then Dr. Ewals submits your new certification.

File a renewal on the state's registration site at least 45 days before your card expires and pay the $40 state fee. Dr. Ewals sees you and completes a new certification online. Your new card is good for another 2 years (checked October 2026).

Every 3 years, Dr. Ewals reassesses you and enters a new certification, then you re-enroll through your online registry account. There's no state fee (checked October 2026).

Apply in the state you live in now; a card from your old state doesn't carry over. Dr. Ewals is licensed in both states, so she can certify you for either program. Bring an ID or other proof of your new address.

Yes, for patients in North Dakota and Minnesota. Tell Will you'd like a video visit when you book.

Yes. Our renewal countdown can add a reminder to your calendar.

Our clinic fees are below. A $50 deposit holds your appointment, and the rest is due before your visit.

• TRT consultation: $200
• Peptide consultation: $200
• Medical cannabis: $250 for a new patient evaluation, or $230 to renew if Dr. Ewals certified you before. Any state registration fee is separate and paid to the state.

No, we do not accept insurance.

Yes, most Health Savings Account (HSA) and Flexible Spending Account (FSA) plans can be used to pay for most of our services. Eligibility depends on your plan and IRS rules. Check with your plan administrator before paying with HSA or FSA funds.

Book online or call Will at (218) 274-4500. He will walk you through the entire process.

You can reschedule free of charge. Fees are not refundable, so please call as early as you can if your plans change.

Yes, we offer North Dakota and Minnesota residents convenient secure HIPAA compliant telehealth consultations for ALL of our services.

If you prefer or require an in-office visit, you can book an appointment in our Grand Forks, North Dakota office. We can accommodate either.

No. Referrals are not required. If another clinician is treating your condition, please share any lab work or diagnoses from within the last year.

Yes. A family member or friend is welcome at the visit if that helps you.

No. Dr. Ewals is licensed in North Dakota and Minnesota, so our visits are for patients in those two states.

Yes. The clinic fee is the same whether you're seen in the office or by video.

Your records with our clinic are protected health information under HIPAA, and we only share them as the law allows or as you authorize. For medical cannabis patients, how the state registry protects your information is set by state law; the state program pages explain it.

Please don't upload them through our booking or question forms, which are for scheduling details only. Email them to info@alternativehealthgf.com or fax them to (701) 757-0974 instead.

The easiest way is to download your visit note from MyChart or another patient portal and email it to info@alternativehealthgf.com. Clinics can also fax records to (701) 757-0974, or you can bring paper copies to your visit. Recent notes about your condition are all we need, not your whole history.

What you type into our forms and chat. The booking form asks for your name, phone, email, the visit you want, your state, whether you're new or returning, how and when to reach you and any scheduling note. The question form and chat take your contact details and question. The forms, booking calendars and chat run on our scheduling system, which sets cookies and notes the page you came from so we can see where requests start. We don't use advertising trackers. Patient intake and consent forms go straight to our electronic health record system and become part of your medical record.

We don't give medical advice by email. Email is the easiest way to send your records (info@alternativehealthgf.com). Anything about your health itself is discussed by phone or at your visit.

Requests go into our scheduling system so we can contact you and follow up. Call us any time to ask us to delete yours. If you become a patient, the details move into your medical record, which is kept as health-record law requires.

• Initial consultation: $200. If you qualify and decide to start treatment, it includes your first month of testosterone, supplies and shipping.
• Every month after that: $190, OR
• Pay $2,000 upfront for the whole year and save $290. ($200 consultation fee is credited toward membership, leaving a balance of $1,800)
• Follow-up visits are included in both plans.
• Lab work is billed separately by the lab you choose. (If you don't have a preference, we can refer you to a lab.)

Request a Consultation

Usually, yes. Call us for a lab order, complete the labs, and then book your visit so Dr. Ewals can review the results with you. Low testosterone is generally confirmed with early-morning blood tests on more than one day, not symptoms alone.

The most common symptoms of low testosterone (low T) are:

1. Reduced sex drive (low libido)
2. Difficulty getting or keeping an erection, including fewer morning erections
3. Persistent fatigue and low energy
4. Loss of muscle mass and strength
5. More body fat, especially around the midsection
6. Depressed mood or irritability
7. Difficulty concentrating, forgetfulness or brain fog
8. Poor sleep
9. Reduced facial or body hair
10. Enlarged or tender breast tissue

Every one of these has other possible causes, including sleep apnea, thyroid problems, medicines and stress. Low testosterone is confirmed with early-morning blood tests, not symptoms alone, which is why we test rather than guess.

According to the Endocrine Society and American Urological Association (AUA), diagnosing low testosterone (male hypogonadism) requires compatible symptoms, low testosterone confirmed by two separate early-morning blood tests, and a medical evaluation to identify potential underlying causes.

Dr. Ewals sets a dose and shows you how the medicine is taken. Your medication and home-use supplies are shipped to you as part of the TRT membership. Follow-up visits are every 8 to 24 weeks, depending on the person, and your dose is adjusted from your lab results.

Once your levels are stable, usually after 2 to 4 months, labs are typically every 3 to 6 months. They check testosterone, red blood cell count and other markers. Labs are billed by the lab and aren't included in the TRT membership.

Two things. After a large trial (TRAVERSE) found no increase in major heart problems, the FDA had testosterone labels updated to reflect those results. It also required a warning that testosterone can raise blood pressure, so Dr. Ewals monitors yours.

Men with or being evaluated for prostate or breast cancer, untreated severe sleep apnea, uncontrolled heart failure or a very high red blood cell count, and men trying to conceive now. Dr. Ewals goes through all of this before anything is prescribed.

Yes. Testosterone therapy can lower sperm production. If you might want children, say so at your first visit so you can discuss other options.

Yes. Email or fax your most recent labs and your last visit note (info@alternativehealthgf.com or (701) 757-0974), then call Will to book. Dr. Ewals reviews your records first. Depending on what they show, she may order additional testing before continuing your treatment.

Short chains of amino acids that act as signals in the body. Some are long-established medicines, such as insulin and the GLP-1 drugs used for diabetes and weight. Many products sold online as “peptides” are not approved for any use.

Insulin, GLP-1 medicines like semaglutide and tirzepatide, and a few others are approved for specific conditions. Products such as BPC-157, ipamorelin and CJC-1295 are not approved for any use, and the FDA has raised safety concerns about compounding them.

We start with a consultation. If a prescription product is appropriate for you and legally available from a licensed pharmacy, Dr. Ewals will explain it. We don't sell research chemicals or products labelled “not for human use.”

It depends on the product. Approved medicines have known risks and quality control. Unapproved products may contain the wrong dose, contaminants or nothing at all, and their long-term effects are unknown. Dr. Ewals will tell you plainly what the evidence does and doesn't show.

$200. A $50 deposit holds your appointment, and the rest is due before your visit. HSA/FSA accepted; whether the expense qualifies depends on your plan.

Some approved medicines, like the GLP-1 drugs, have strong evidence for weight loss. For most other peptides marketed for muscle, recovery or anti-aging, the evidence in people is thin or missing. We won't promise results the research doesn't support.

Bring it or a photo of the label. Dr. Ewals can tell you what the product claims to be, what's known about it and the risks. We can't vouch for the contents of unregulated products.

Prescription peptide medicines are legal with a valid prescription. Products sold “for research use only” aren't approved for people, and pharmacies are restricted from compounding several of them. Buying them for personal use puts you outside any safety net.

Not always. Bring any recent lab results and a list of your medicines; Dr. Ewals will tell you if more testing would help.

No. They're separate consultations. Some men ask about both, and Dr. Ewals can discuss how they relate, but neither is a shortcut to the other.

Dr. Charlotte Ewals, DNP, FNP-BC, at every visit. There are no rotating providers.

Dr. Ewals holds a Doctor of Nursing Practice degree, which is where “Dr.” comes from, and is a board-certified family nurse practitioner licensed to evaluate, diagnose and prescribe. She is not a physician.

Our office manager. He answers the phone, books visits, takes payment, explains how to send records securely and returns messages. If you've called us, you've probably spoken with him.

2502 S. Washington St, Grand Forks, ND 58201, with a parking lot on site. A map and directions are on our Visit page.

Visits are by appointment. Call (218) 274-4500 and Will will find a time that works, including how quickly you can be seen.

Yes. There's a parking lot right outside the clinic, a wheelchair-accessible ramp into the building and an accessible restroom. Tell Will about any other needs when you book.

We only display reviews we've confirmed on Google and that the reviewer has agreed to share. If you'd like to leave one, there's a link to our Google listing in the footer.

Call Will or use the contact form. Feedback goes to Dr. Ewals directly, and we'd rather hear about a problem than not.

Not as a dedicated service right now. Women are welcome for medical cannabis evaluations. Call and we'll point you in the right direction for hormone care.