Releaf Focus Group
This is an application to attend the FREE Releaf Patient Focus Group. Please review the pre-requisites prior to submitting an application.

• Patients must be located in the DC, Maryland, Virginia area. Age 21 and above only.
• Each patient must have an iPhone 4s or later with iOS 9.0 or later installed.
• Each patient must have an identifiable medical symptom(s) that they would like to treat with cannabis.
• No medicating 24 hours prior to session to lower the patient’s tolerance level and increase potential feedback
• Patients must sign a medical waiver prior to testing.
• Medicating methods will be limited to smoking for this group (Vaporizer, Papers/Wraps, or water pipes/pipes)
• One application per patient. Multiple applications submitted will automatically disqualify.

First Name *
Your answer
Email Address *
Your answer
Contact Number (only contact you if accepted) *
Your answer
What are your current primary symptom that you treat with cannabis? *
How long have you been using cannabis for your current symptom(s) *
How much cannabis do you consume on a weekly basis? *
What is your preferred method for medicating with Cannabis? *
What is your preferred type of cannabis for treating your symptoms? *
What version of iPhone do you have? *
What size t-shirt are you?
Patient Feedback / Questions / Special Needs (we will do our best to respond)
Your answer
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