Consent to Act as a Research Participant

Physical Therapist Attitudes and Patient Use of Marijuana as an Adjunct to Physical Therapy

Survey from Humboldt State University and Humboldt Institute for Interdisciplinary Marijuana Research

Dear Colleague,

Your answers to these questions are completely anonymous. To help maintain your privacy remember to not put any personally identifying information (such as your name or address) on this survey.

You qualify for this study if you are a licensed physical therapist (PT) or physical therapist assistant (PTA) and can help us a great deal by answering these questions. With this information we can better understand Physical Therapists attitudes toward medical marijuana and help others. Also, please only take the survey once.

Thank you for participating!

PURPOSE: The primary aim of this study is to understand how physical therapists view patients’ use of medical marijuana. In order to gain a more complete picture of the intersection between physical therapy and medical marijuana, we aim to survey current adult physical therapy patients who are also prescribed medical marijuana.  The patient perspective and use behaviors are important for physical therapists to understand to ensure safety and enhance patient education in the context of physical therapy intervention.

I understand that my participation in any study is entirely voluntary, that I must be at least 18 years or older to participate, and that I may decline to enter each study or withdraw from any of the studies at any time without jeopardy.  I also understand that the investigator may terminate my participation in the study at any time.

I consent to the following procedures:
- Filling out the attached survey on Cannabis

Total Length of Study: 20 minutes

Location of Study: Online

Primary Investigator: Dr. Whitney Ogle DPT

I understand that the researchers will keep my participation confidential and completely anonymous by not collecting any individually identifiable information. I understand that by participating in research, I will receive the benefit of contributing to a greater understanding of professionals’ attitudes and understanding of Medical Marijuana.  This will help in the development of meaningful continuing education of medical marijuana and endocannabinoids for physical therapists.

If you have any concerns with this study or questions about your rights as a participant, contact the Institutional Review Board for the Protection of Human Subjects at or (707) 826-5165.

If I have questions, I may also contact Dr. Whitney Ogle at

Question Title

* 1. I have read, received a copy of, and understand this form: