Survey: PMS and Cannabis (Primary Dysmenorrhea)
Thank you for choosing to participate in the My Compassion Survey: PMS and Cannabis (Primary Dysmenorrhea).
Please fill out the survey below and click ‘Submit’ when you are finished.
Email address *
Name *
Your answer
Age *
Your answer
Email *
Your answer
Gender *
Do you suffer from Menstrual Cramps? *
On a scale of 1 -10 how severe is the pain? *
minimum pain
maximum pain
Do you use cannabis? *
If yes how? *
On a scale of 0 - 10 does cannabis relieve your cramping? *
no effect
complete relief
Have you been diagnosed with Primary Dysmenorrhoea? *
Would you be willing to learn more about petitioning the state of Michigan to include Primary Dysmenorrhoea (PMS) as a qualifying condition? *
Would you be intrested in a research study for using cannabis to treat Primary Dysmenorrhoea? *
A copy of your responses will be emailed to the address you provided.
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service