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* 1. Name

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* 2. VA Medical Center

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* 3. Email address

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* 4. Indicate the role you would be interested in

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* 5. Indicate what health conditions you would be interested in studying related to benefits/risks of medical marijuana

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* 6. If you are interested in a PI role, what type of study would you be proposing? 

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* 7. List special research resources you have available (if applicable)

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* 8. Describe any specific experience related to medical marijuana that could be of interest

THANK YOU SO MUCH FOR YOUR PARTICIPATION!!
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