Intake

What is your registry identification number?

* What is the name of the Cannabis or Cannabis-infused product you would like to give feedback on?

* Please tell us approximately when you purchased the product.

On a scale of 1 to 5 (1 = no effect, 5 = strongest effect) please indicate how the product relieved your symptoms.

1 2 3 4 5
Pain
Muscle Spasm
Nausea
Insomnia
Stress
Anxiety
Loss of Appetite
When it the best time to take this product?



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