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.

PRE-REQUISITES
• 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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