Capstone Project Kapuna

University of Maryland School of Pharmacy

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* 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?

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

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?

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?

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?

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?

Describe what you know about them:

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

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?

Yes

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

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

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* 3. Age

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* 4. Gender

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* 5. Ethnicity

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

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

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* 8. What is your preferred route of administration?

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

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

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

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* 12. Are you familiar with THC and CBD?

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

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

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

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

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