Other (please specify)

Other (please specify)

I find it easier to remember things when I am not smoking marijuana regularly.

I find it easier to remember things when I am not smoking marijuana regularly.

It’s more difficult to concentrate.

It’s more difficult to concentrate.

My memory is not as sharp as it was before smoking marijuana.

My memory is not as sharp as it was before smoking marijuana.

It has not affected my cognition or memory.

It has not affected my cognition or memory.

What effect has marijuana had on your cognition and memory? Check all that apply.

Have you benefitted from using marijuana for medical purposes? Explain.

Very often

Very often

Have you experienced paranoia or increased anxiety after using marijuana?

If yes, why?

If yes, why?

Have you ever been admitted into the hospital after using marijuana?

Other (please specify)

Other (please specify)

No ; Never occured

No ; Never occured

Yes ; Very often

Yes ; Very often

Have you experienced nausea, vertigo, and/or vomiting after using marijiana?

Other (please specify)

Other (please specify)

On occasion, when I need it for medical purposes

On occasion, when I need it for medical purposes

How often do you use marijuana?

All the time

All the time

Have you experienced difficulty getting up, thoughts of suicide, or other signs of depression since prescribed marijuana?

Why do you smoke marijuana? Check all that apply.

over 10 years 5-8 years 2-4 years 1 year less than a year or never

Approximately how long have you been using marijuana?

17 and under 18-25 26-40 40 years and older

How old are you?

T

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