Cannabis Survey for Medical & Recreational Use
Fill out this short survey to help us determine cannabis use needs as we fight for federal legalization in the United States foremost for medical use to ease the suffering of patients but also to prove their are many people wanting legalization for recreational use as well. No name is required so feel free to be honest and answer every question you can. The National Cannabis Patients Wall will use this information to validate our claims of need. Please share the survey on all social networks.
Are you currently being denied access to medical cannabis in your state?
Use other if you want to add a comment about how that affects you.
Do you use cannabis for medical or recreational purposes, or both?
Both medical and recreational
How long have you used cannabis?
Less than 1 year
More than 1 year but less than 2
More than 2 year but less than 3
More than 3 year but less than 4
More than 4 year but less than 5
More than 5 year but less than 6
More than 6 year but less than 7
More than71 year but less than 8
More than 8 year but less than 9
More than 9 year but less than 10
More than 10 year but less than 11
More than 11 year but less than 12
More than 12 year but less than 13
More than 13 year but less than 14
More than 14 year but less than 15
More than 15 year but less than 16
More than 16 year but less than 17
More than 17 year but less than 18
More than 18 year but less than 19
More than 19 year but less than 20
More than 20 years
Current age of the person this information on the form is about. Family members are welcome to participate and should fill the form out for each family member seperately we need all of the input we can get.
18 - 25
26 - 35
36 - 50
51 - 60
61 - 70
If you use medically what illness or illnesses do you use cannabis for?
Check all illnesses that cannabis helps relieve symptoms of.
A chronic or terminal disease
Arnold-Chiari Malformation & Syringomyelia
Cachexia (wasting syndrome)
Cancer (List specific type of cancer in followup)
Cardiopulmonary Respiratory Syndrome
Chronic inflammatory (demyelinating
Inflammatory Bowel Disease (IBS)
Lou Gehrig's disease ( ALS)
Muscle Spasms or Spasticity
Painful Peripheral Neuropathy
Post-traumatic Stress Disorder (PTSD)
Reflex Sympathetic Dystrophy
Spinal Cord Disease & Injury
Diseases which result in nausea
WHAT KIND OF CANNABIS & DELIVERY METHODS USED
Do you use Indica, Sativa, or a combination of both?
Combination of Sativa and Indica
What is the name(s) of your favorite strain(s)
List your top 3 favorite strains of cannabis.
Why are they your favorite strains? What favorible effect (s) make these your favorite strain(s) of cannabis.
Relieves pain, stress, depression, nasaua, etc... or Makes me feel .....
What type(s) of delivery system(s) do you use?
How do you take your cannabis? Check all that apply.
Eat raw as a vegetable.
Vegging or blending in mixer with fruits or vegetables.
Cook it into foods to make edibles.
Processed into cannabis oil.
Processed into topical applications.
Processed into hashish and smoked.
Smoke cannabis flowers.
Given the new scientific evidence of the health benefits of cannabis would you try new cannabis therapies.
If you had only smoked cannabis before would you try eating it, vegging it into a smoothie, or applying it toppically?
Yes I would try a new cannabis therapies.
No I would not try new cannabis therapies.
HOW MUCH CANNABIS USED FOR MEDICAL OR RECREATIONAL PURPOSES
These questions are very important as they will help determine the number of plants needed for a patients medical needs depending on their personal cannabis therapies or for citizens personal use. This information is useful for setting legal grow and use limits and as reference material for patients/members learning about cannabis use.
How many times per day do you eat or drink cannabis, edibles, and or drinks?
I do not currently eat or drink cannabis
More than five times.
How many times per day do take cannabis oils?
I do not currently take cannabis oils.
More than five times.
How many times per day do apply cannabis topically?
I do not currently apply cannabis topically.
More than five times.
How many times per day do you smoke or vaporize cannabis or its extracts?
More than five times.
How much cannabis do you eat or drink each day.
How much raw plant material is needed to make your oils, edibles, and or drinks
I do not eat or drink cannabis
Less than 1/8 ounce per day
More than 1/4
How much cannabis do you smoke or vaporize each day.
The US Government prescribes 9 oz per patient per month in the Compassionate IND program = 12 joints per day. How much do you or would you smoke is allowed.
Less than 1/8 ounce per day (5 joints)
1/4 Ounce (10 joints per day)
More than 1/4 Ounce per day
Do you currently grow your own cannabis?
If given the opportunity would you grow your own cannabis?
If cannabis was on the ballot for legalization of medical use would you vote for it?
If cannabis was on the ballot for legalization of recreational use would you vote for it?
What state do you live in
DC District of Columbia
QUESTIONS FOR THOSE THAT HAVE PREVIOUSLY GROWN CANNABIS
These questions are very important as they will be valuable in determining the number of plants needed by each patient for their medical needs depending for their personal cannabis therapies.
Do you usually only grow indoor or outdoor to provide for your medical or recreational needs?
I usually grow indoors
I usually grow outdoors.
I grow both in and out of doors
Do you need to grow indoor and outdoor to provide for your medical or recreational needs?
I grow 1 outdoor crop and 1 indoor crop
I grow 1 outdoor crop and 2 indoor crops
I grow 1 outdoor crop and 3 indoor crops
If you grow outdoors are you able to grow enough for the year in one crop?
One grow provides for my yearly needs.
One grow does not provide for my yearly I needs. I have to grow two crops per year
How many plants do you need to grow to provide for your medical or recreational needs for a year?
1 to 12
13 to 25
26 to 50
51 to 75
75 to 100
More than 100
Do you grow all of the same strain of plants every season?
Yes all the same strain.
No I grow different strains.
Do you grow all Indica or all Sativa but more than one strain?
I grow a few different strains of Indica
I grow a few different strains of Sativa
Do you grow some Indica and some Sativa plants in one crop?
Mostly Indica with a few Sativa plants.
Mostly Sativa with a few Indica plants.
I grow half Indica and half Sativa plants.
On average how much does it cost you to grow an outdoor cannabis crop.
On average how much does it cost you to grow an indoor cannabis crop.
FOR CONTEST PURPOSES ONLY: NOT REQUIRED
To enter our giveaways you need to provide your facebook username and if you are referred by a friend please add their name so they get credit and earn an extra entry. Thanks for playing and good luck.
Your facebook username. We can not enter you without your username.
Reffered by: Your friend will not get credit unless you put their username here.
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