Patient Medical Cannabis Use Survey

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Cannabis Use Report

This will take you less than 4.20 minutes ;)
The information you provide below is kept confidential. Your responses will contribute to research and advocacy to improve Medical Cannabis access. Thank you for your time and honest responses on all cannabis use, whether medical, recreational, or other.
Name*

First NameLast Name
Email*
example@example.com
Date of Birth

MonthDayYear
Date
Age*
Gender
Race / Ethnicity (select all that apply)
Annual household income
About how much do you spend on cannabis per month?
How long have you been using cannabis?
I consume cannabis by (select all that apply):
Frequency of use:
On the days I use cannabis, I use it:
Amount of raw flower you consume per week?
How long does a 1g (large) vape cartridge last you?
My typical Edible dose of THC is:
Where do you get your Cannabis? (select all that apply)
I mainly use cannabis for:
Cannabis helps my main medical concern.
Cannabis helps me more than prescription medications.
I enjoy using cannabis outside of my medical treatment plan.
I take breaks from cannabis use.
Why do you take breaks?
How long are your breaks?
How often are your breaks?
In the past 6 months, I have taken less of these medications:
Which medications have I reduced? (including other)
I've reduced at least one medication by:
I recommend these products for someone with my condition:
I would like to see more:
Please share your thoughts!
I felt comfortable answering this survey honestly.
Your responses will be kept confidential.
Should be Empty:

Cannabis Use Report