Cannabis in Your Community

Cannabis in Your Community

Please take a few minutes to tell us more about you and your preferences
Name *

First Name Last Name
Phone Number *
Please enter a valid phone number.
Please share your email address *
example@example.com
What is the zip code of your primary residence? *
What is your gender? *

Female Male Non-binary Transgender Prefer not to answer
What is your race? *

White Black or African American Native American/ Indigenous or Alaska Native Native Hawaiian or Pacific Islander Asian
What is your age range? *

0-17 18-24 25-34 35-44 45-54 55-64 65+
What is your ethnicity? *

Hispanic or Latino Non Hispanic/ Latino
Do you have children? *

Yes No
Which would best describe cannabis? *

Drug Medicine
Are you in support of recreational cannabis *

Yes No
Are you in support of medical cannabis? *

Yes No
Are you in support of cannabis being sold on Mesilla Valley Pharmacy premises? *

Yes No
Are you in support of cannabis being sold on Mesilla Valley Pharmacy premises, even though they directly share a wall with a school? *

Yes No
Would you be in support of another dispensary, not ran by pharmacists, selling cannabis within 300ft of the school? *

Yes No
Are you aware there is another dispensary approved within the same 300ft radius to the school? *

Yes No
Are you aware that there is a restaurant that serves alcohol and beer within the same 300ft radius to the school? *

Yes No
Do you use cannabis, either recreationally or medically? *

Yes No
Do you currently take any medications? *

Yes No
Has a healthcare professional ever talked to you about the interactions of cannabis and medications you are taking? *

Yes No
Would you be willing to sign a petition in support of our pharmacy selling cannabis? *

Yes No
Would you be willing to write an email/ letter in support of our pharmacy selling cannabis? *

Yes No
May we contact you using the email and/ or phone number you provided at the beginning of this survey? *

Yes No
Which form of communication would you prefer? *

Email Phone Either
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