Medical Cannabis Survey

We are interested in the extent to which cannabis may have helped specific symptoms of your condition. For each symptom listed below, please indicate whether (i) you used cannabis for that symptom and if used, the extent of relief you received from cannabis on the scale provided.

Symptom relief required

Used cannabis for this symptom

Yes
No

Cannabis used with.....

Nausea relief
Pain relief
Relief through relaxation
Other

Listed below are a number of effects that people may experience from using various medicines or cannabis. Please indicate: whether you have experienced any of these effects when using either cannabis or other medicines for your medical condition(s)

Select all that apply

Have you ever stopped using cannabis only to find that your symptoms or condition returned?

Yes
No

Please give details of the condition/symptoms:

Have you ever stopped using cannabis for medical reasons and experienced any symptoms that you believed were unrelated to your medical condition?

Yes
No

Please give details of these symptoms.

How would you describe undesirable effects produced by cannabis compared with undesirable effects produced by your usual medicines?

Cannabis produced much worse effects than other medicines
Cannabis produced somewhat worse effects than other medicines
Undesired effects about the same with cannabis and other medicines
Other medicines produced somewhat worse effects than cannabis
Other medicines produced much worse effects than cannabis
I have no undesirable effects from cannabis

Overall, how does (or did) cannabis compare with your other medicines in giving you relief from your condition?

Other medicines work much better than cannabis
Other medicines work a bit better than cannabis
Other medicines work about the same as cannabis
Cannabis works a bit better than other medicines
Cannabis works much better than other medicines
Only cannabis gives me relief from my condition

Have you had any symptoms or condition(s) that have not been helped by cannabis at all?

Yes
No

Please give details.

Where do you (did you) obtain your cannabis from?

I grow my own
from friends or family in your area
from a dealer in your area
from friends or family out of your area
from a dealer out of your area
from a ‘club’ or ‘Co operative’ type outlet
Other

Please specify.

If you have more than one source of cannabis, please indicate the proportion (%) of your cannabis coming from each source.

IF YOU PURCHASED CANNABIS, please give an estimation of the cost of your medical cannabis use.

Have you noticed much variation in the cannabis you have used? For example, have you noticed much variability in the effectiveness of the cannabis, or any side-effects depending on the source or batch you used at different times?

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