Capstone Project Kapuna

University of Maryland School of Pharmacy

Question Title

1. MCST Student Representative

Alexis Muller

Jacob Szakal

Karen McNulty

Shoshanna Robinson

Steve Landuyt

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2. Initials of your name

Initials:

Full Name:

Prefer not to give:

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3. Age

65-70

71-75

76-80

81-85

86-90

90+

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4. Gender

Male

Female

Elect not to answer

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5. Ethnicity

White or Caucasian

Black or African American

Hispanic or Latino

Asian or Asian American

American Indian or Alaska Native

Native Hawaiian or other Pacific Islander

Another race

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6. Do you currently live in a state with a medical marijuana program? (Required.)

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7. Have you ever used marijuana? If yes when is the last time you consumed marijuana? (Required.)

Yes

within the past month

< 6 months

1 year

2 years

3 years

4 years

> 5 years

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8. What is your preferred route of administration? (Required.)

smoking/vaping

edibles/gummies

tinctures/drops

topical/cream

topical/patch

None of the above

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9. What route of administration are you willing to try? (Required.)

smoking/vaping

edibles/gummies

tinctures/drops

topical/cream

topical/patch

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10. What are you trying to relieve or what issues do you have? (Required.)

Chronic pain

Anxiety

Insomnia (trouble with sleep)

Cancer

Migraine headaches

Multiple sclerosis

Opioid use disorder

Post-traumatic stress disorder

Seizure disorder, including epilepsy

Terminal illness

Glaucoma

Inflammatory bowel disease, including Crohn's disease

Tourette syndrome

Depression

Other (please specify)

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11. Are you currently taking any of the following medications?

Blood thinners

Anti-anxiety

Anti-depressions

Hypertension meds

Pain relievers including opioids

Seizure medications

None of the above

Other (please specify)

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12. Are you familiar with THC and CBD?

Yes

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13. Do you know how THC & CBD are different? (Required.)

Describe what you know about them:

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14. Are you familiar with terpenes (smells & aromas) naturally occurring in marijuana? (Required.)

Yes

Myrcene

Limonene

Linalool

Caryophyllene

Pinene

I don't know any of these

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15. Do you know how to access or register for a medical marijuana card? (Required.)

Yes

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16. What kind of educational support would you like? (Required.)

Participate in an online education program on medical marijuana

Participate in an in-person community education program on medical marijuana

Educational material on how to access medical marijuana state programs

A reference guide on talking to your doctor about medical marijuana

Share your learning and experiences with a family member

A pocket guide of the top 3-5 questions to ask at a dispensary

None of the above

Capstone Project Kapuna

University of Maryland School of Pharmacy

Question Title

* 1. MCST Student Representative

Question Title

* 2. Initials of your name

Question Title

* 3. Age

Question Title

* 4. Gender

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* 5. Ethnicity

Question Title

* 6. Do you currently live in a state with a medical marijuana program? (Required.)

Question Title

* 7. Have you ever used marijuana? If yes when is the last time you consumed marijuana? (Required.)

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* 8. What is your preferred route of administration? (Required.)

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* 9. What route of administration are you willing to try? (Required.)

Question Title

* 10. What are you trying to relieve or what issues do you have? (Required.)

Question Title

* 11. Are you currently taking any of the following medications?

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* 12. Are you familiar with THC and CBD?

Question Title

* 13. Do you know how THC & CBD are different? (Required.)

Question Title

* 14. Are you familiar with terpenes (smells & aromas) naturally occurring in marijuana? (Required.)

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* 15. Do you know how to access or register for a medical marijuana card? (Required.)

Question Title

* 16. What kind of educational support would you like? (Required.)

Question Title

* 17. What is the one thing you want to know about medical marijuana that we haven't asked?

1. MCST Student Representative

2. Initials of your name

3. Age

4. Gender

5. Ethnicity

6. Do you currently live in a state with a medical marijuana program? (Required.)

7. Have you ever used marijuana? If yes when is the last time you consumed marijuana? (Required.)

8. What is your preferred route of administration? (Required.)

9. What route of administration are you willing to try? (Required.)

10. What are you trying to relieve or what issues do you have? (Required.)

11. Are you currently taking any of the following medications?

12. Are you familiar with THC and CBD?

13. Do you know how THC & CBD are different? (Required.)

14. Are you familiar with terpenes (smells & aromas) naturally occurring in marijuana? (Required.)

15. Do you know how to access or register for a medical marijuana card? (Required.)

16. What kind of educational support would you like? (Required.)

17. What is the one thing you want to know about medical marijuana that we haven't asked?