Age: (please mark one)
17 or under 17
18-24
25-29
30-34
35-39
40-44
45-49
50-54
55-59
60-64
65 or older
Gender: (please mark one)
-Male x
-Female
Ethnicity: (please mark one)
-Caucasian x
-Black/African Descent
-Hispanic/Latin
-Asian
-American Indian/Alaskan Native
-Other:
Are you a regular smoker or user of tobacco products? ( Y / N ) y
-If no, have you ever used a tobacco product? ( Y / N )
Are you a regular consumer of alcohol? ( Y / N ) y
-If no, have you ever tried alcohol? ( Y / N )
Have you ever tried marijuana? ( Y / N ) y
If yes:
How often do you smoke? (please mark one)
-Less then 3 times ever.
-more then 5 times but haven't in over a year.
-Weekly
-Biweekly
-Every day x (Like 3 times a week but theres nothing like that her so every day)
-Monthly
-Between Monthly and yearly.
What Age were you first introduced to Marijuana?
17 or under x (I was like 12 lol)
18-24
25-29
30-34
35-39
40-44
45-49
50-54
55-59
60-64
65 or older
Have you ever been convicted for a marijuana-affiliated crime? ( Y / N ) n
Do you consider Marijuana a gateway drug? ( Y / N ) n
Do you believe there are medical benefits to Marijuana? ( Y / N ) y
Are you in favor of legalizing Marijuana? ( Y / N ) hell yes
Do you use medical Marijuana or ever been perscribed? (Y/ N) n
-If so, did you get any relief from your symptoms and would use it again? (Y/N)
-Would you ever recommend it to a friend? (Y/N)
Would you be willing to pay for medical marijuana if legalized? (Y/N) y
Do you know of any doctors that persrcibe medical marijuana? (Y/N) n
Do you think medical maraijuana will ever be accepted? (Y/N) y
17 or under 17
18-24
25-29
30-34
35-39
40-44
45-49
50-54
55-59
60-64
65 or older
Gender: (please mark one)
-Male x
-Female
Ethnicity: (please mark one)
-Caucasian x
-Black/African Descent
-Hispanic/Latin
-Asian
-American Indian/Alaskan Native
-Other:
Are you a regular smoker or user of tobacco products? ( Y / N ) y
-If no, have you ever used a tobacco product? ( Y / N )
Are you a regular consumer of alcohol? ( Y / N ) y
-If no, have you ever tried alcohol? ( Y / N )
Have you ever tried marijuana? ( Y / N ) y
If yes:
How often do you smoke? (please mark one)
-Less then 3 times ever.
-more then 5 times but haven't in over a year.
-Weekly
-Biweekly
-Every day x (Like 3 times a week but theres nothing like that her so every day)
-Monthly
-Between Monthly and yearly.
What Age were you first introduced to Marijuana?
17 or under x (I was like 12 lol)
18-24
25-29
30-34
35-39
40-44
45-49
50-54
55-59
60-64
65 or older
Have you ever been convicted for a marijuana-affiliated crime? ( Y / N ) n
Do you consider Marijuana a gateway drug? ( Y / N ) n
Do you believe there are medical benefits to Marijuana? ( Y / N ) y
Are you in favor of legalizing Marijuana? ( Y / N ) hell yes
Do you use medical Marijuana or ever been perscribed? (Y/ N) n
-If so, did you get any relief from your symptoms and would use it again? (Y/N)
-Would you ever recommend it to a friend? (Y/N)
Would you be willing to pay for medical marijuana if legalized? (Y/N) y
Do you know of any doctors that persrcibe medical marijuana? (Y/N) n
Do you think medical maraijuana will ever be accepted? (Y/N) y