JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Project Twenty21 Case Studies
We want to encourage more patients and prescribers to join Project Twenty21 in order to gather the data to encourage UK drug policy change and more medical cannabis prescriptions on the NHS.
If you are happy to share your experience please complete this form.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
What is your condition and what are your symptoms?
*
Your answer
What medicines were you prescribed before medical cannabis?
*
Your answer
How did you find out about Project Twenty21?
*
Your answer
How has medical cannabis and ProjectTwenty21 changed your life?
*
Your answer
Any other feedback?
Your answer
Full name
*
Your answer
Age
*
Your answer
Email address
*
Your answer
Location
Your answer
Occupation
Your answer
Please can we share your quotes anonymously?
*
Yes
No
Please can we share your quotes with your name, location and job role on our website, social media platforms and in educational material?
*
Yes
No
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. -
Terms of Service
-
Privacy Policy
Does this form look suspicious?
Report
Forms
Help and feedback
Contact form owner
Help Forms improve
Report
