This is a survey I developed for my Master's thesis. I will use it to find out if patients had used the services of medical marihuana educational groups called Compassion Clubs, and how the attendance of said meetings helped or influenced their knowledge or medication usage.
Return completed surveys to me at [email protected] OR mail to:
Motor City Compassion Group P O Box 21002 Detroit MI 48221 by 9/30/11
Thanks,
Ms. Chocolate
I am conducting a survey on the Michigan Medical Marihuana Act. You can help by answering the following questions. Your answers should be as detailed as you are comfortable. Please PRINT your responses.
MS. CHOCOLATES MICHIGAN MEDICAL MARIHUANA SURVEY 2011
INTRODUCTION
Have you ever used marihuana as a medication?
Do you use medical marihuana now?
PERSONAL INFORMATION
Gender
Age
Area of Residence Zip Code
Highest educational level completed?
What is your qualifying medical condition?
What is your Race or Ethnic group?
Are you presently employed?
Do you presently have health insurance?
PATIENT STATUS
Are you a patient?
Are you registered with the State?
Do you grow your own medication?
Do you acquire your material from other patients?
Do or have you acquired from a dispensary?
CAREGIVER STATUS
Are you a caregiver?
How many patients are you registered under?
Do you grow your own medication?
How do you acquire your material for your patient(s) from other patients?
Have you acquired from a dispensary?
Have you transferred material to a dispensary?
GROW ROOM INFORMATION
What grow medium to you use (i.e. soil, hydro, aero, other)?
What type of enclosed, locked facility do you employ (room, basement, closet, tent, cabinet, other)?
What type of lighting system to you use?
MODE OF USE
Were your aware that marihuana could be consumed in ways other than smoked?
If so, where did you gain this knowledge?
Do you use a topical application?
Do you ingest your medication?
How?
Do you utilize more than one mode of use?
What?
Why?
How often do you use your medication per day? What times per day?
How much marihuana do you use per day?
What is your dosage size?
<1 grams
2 3 grams
>4 grams
How much do you spend on your cannabis treatment each month?
OTHER FORMS OF ALTERNATE TREATMENTS USED check all that apply
Physical Therapy Pain Medications
Chiropractic Acupuncture
Homeopathy Others
POSITIVES AFFECTS OF USE
Since using cannabis, have you noticed improvements regarding your qualifying symptoms?
Please explain.
If yes, have you noticed improvement in your quality of life?
Please explain.
Before using cannabis, what other medications had you used (name)?
Are you still using these other medications?
Are you using less of these other medications?
How much to you spend each month for these other medications?
NEGATIVES AFFECTS OF USE
Since April 6, 2009; have you had any negatives affects that resulted from your marihuana use (employment, child care, housing, legal, other)?
If so, please explain.
UNDERSTANDING OF THE MICHIGAN MEDICAL MARIHUANA ACT
Did you vote in favor of the 2008, Michigan Medical Marihuana Act?
Where did you find information explaining the Michigan Medical Marihuana Act (a web site, local library, other)?
MEDICAL MARIHUANA COMPASSION CLUBS/ MEDICAL MARIHUANA EDUCATIONAL MEETINGS
For the purpose of this survey, Compassion Clubs are the community-based, educational and support groups whose interest is in sharing information pertaining to the medical use of marihuana.
Are you familiar with Medical Marihuana Compassion Clubs?
Have you ever attended a Compassion Club meeting? Why or Why not?
If you have attended a meeting, what were your expectations?
Did these meetings meet your expectations? How or how not?
Were the meeting times convenient? Why or why not?
Was the location convenient?
Was the setting comfortable and secure?
Was the host/hostess knowledgeable about the law?
Did the Club provide guest speakers?
If so, what information or topic did the speakers share?
Was this information helpful to you?
Add addition comments concerning your (or that of a loved one) use of cannabis and its effect on your health and health care.
There are Bills pending, in both the Michigan House and Senate, which relate to the medical use of marihuana, and may circumvent the Medical Marihuana Act that was approved by voters in 2008.
Here are samples of Bills that are being considered.
Senate Bill 17 would amend the Public Health Code to prohibit a person from organizing or operating a marihuana club or bar; or knowingly allowing land or a structure on land he or she owned or possessed to be used as a marihuana club or bar.
SB 259 - would ban any synthetic equivalents of the substances contained in the plant, or in the resinous extractions of cannabis and synthetic substances, derivatives, and their isomers with similar chemical structure or pharmacological activity, or both.
SB 321 - will not allow a person receiving personal protection insurance coverage due to an auto accident to receive marihuana as medication.
SB 377 - will dismiss the privacy aspect of the Medical Marihuana Act, and allow the names of patients to be distributed to law enforcement agencies.
SB 418 this bill will make it impossible to sue or create a private cause of action against the State or a political subdivision of this State.
SB 504 this will establish a buffer whereby a person can be prosecuted if they conduct a transfer of marihuana within 1,000 feet from a clearly identified house of worship or school, other than a home school, unless the transfer occurs inside the residence of a qualifying patient who has been issued and possesses a registry identification card.
SB 505 the 2008 law disallows a person with drug related felonies from being a caregiver, this bill would disallow persons with any type of felony from being a caregiver.
SB 506 defines a bona fide physician/patient relationship
House Bill 4850 makes it illegal for patients to acquire or transfer marihuana.
H B 4854 will make it illegal for a caregiver to advertise for or to patients; or of the availability of marihuana.
What are your opinions of the purposed changes?
If there are to be changes, should they be made by legislators or the voters? Why?
Share This Entry:
Return completed surveys to me at [email protected] OR mail to:
Motor City Compassion Group P O Box 21002 Detroit MI 48221 by 9/30/11
Thanks,
Ms. Chocolate
I am conducting a survey on the Michigan Medical Marihuana Act. You can help by answering the following questions. Your answers should be as detailed as you are comfortable. Please PRINT your responses.
MS. CHOCOLATES MICHIGAN MEDICAL MARIHUANA SURVEY 2011
INTRODUCTION
Have you ever used marihuana as a medication?
Do you use medical marihuana now?
PERSONAL INFORMATION
Gender
Age
Area of Residence Zip Code
Highest educational level completed?
What is your qualifying medical condition?
What is your Race or Ethnic group?
Are you presently employed?
Do you presently have health insurance?
PATIENT STATUS
Are you a patient?
Are you registered with the State?
Do you grow your own medication?
Do you acquire your material from other patients?
Do or have you acquired from a dispensary?
CAREGIVER STATUS
Are you a caregiver?
How many patients are you registered under?
Do you grow your own medication?
How do you acquire your material for your patient(s) from other patients?
Have you acquired from a dispensary?
Have you transferred material to a dispensary?
GROW ROOM INFORMATION
What grow medium to you use (i.e. soil, hydro, aero, other)?
What type of enclosed, locked facility do you employ (room, basement, closet, tent, cabinet, other)?
What type of lighting system to you use?
MODE OF USE
Were your aware that marihuana could be consumed in ways other than smoked?
If so, where did you gain this knowledge?
Do you use a topical application?
Do you ingest your medication?
How?
Do you utilize more than one mode of use?
What?
Why?
How often do you use your medication per day? What times per day?
How much marihuana do you use per day?
What is your dosage size?
<1 grams
2 3 grams
>4 grams
How much do you spend on your cannabis treatment each month?
OTHER FORMS OF ALTERNATE TREATMENTS USED check all that apply
Physical Therapy Pain Medications
Chiropractic Acupuncture
Homeopathy Others
POSITIVES AFFECTS OF USE
Since using cannabis, have you noticed improvements regarding your qualifying symptoms?
Please explain.
If yes, have you noticed improvement in your quality of life?
Please explain.
Before using cannabis, what other medications had you used (name)?
Are you still using these other medications?
Are you using less of these other medications?
How much to you spend each month for these other medications?
NEGATIVES AFFECTS OF USE
Since April 6, 2009; have you had any negatives affects that resulted from your marihuana use (employment, child care, housing, legal, other)?
If so, please explain.
UNDERSTANDING OF THE MICHIGAN MEDICAL MARIHUANA ACT
Did you vote in favor of the 2008, Michigan Medical Marihuana Act?
Where did you find information explaining the Michigan Medical Marihuana Act (a web site, local library, other)?
MEDICAL MARIHUANA COMPASSION CLUBS/ MEDICAL MARIHUANA EDUCATIONAL MEETINGS
For the purpose of this survey, Compassion Clubs are the community-based, educational and support groups whose interest is in sharing information pertaining to the medical use of marihuana.
Are you familiar with Medical Marihuana Compassion Clubs?
Have you ever attended a Compassion Club meeting? Why or Why not?
If you have attended a meeting, what were your expectations?
Did these meetings meet your expectations? How or how not?
Were the meeting times convenient? Why or why not?
Was the location convenient?
Was the setting comfortable and secure?
Was the host/hostess knowledgeable about the law?
Did the Club provide guest speakers?
If so, what information or topic did the speakers share?
Was this information helpful to you?
Add addition comments concerning your (or that of a loved one) use of cannabis and its effect on your health and health care.
There are Bills pending, in both the Michigan House and Senate, which relate to the medical use of marihuana, and may circumvent the Medical Marihuana Act that was approved by voters in 2008.
Here are samples of Bills that are being considered.
Senate Bill 17 would amend the Public Health Code to prohibit a person from organizing or operating a marihuana club or bar; or knowingly allowing land or a structure on land he or she owned or possessed to be used as a marihuana club or bar.
SB 259 - would ban any synthetic equivalents of the substances contained in the plant, or in the resinous extractions of cannabis and synthetic substances, derivatives, and their isomers with similar chemical structure or pharmacological activity, or both.
SB 321 - will not allow a person receiving personal protection insurance coverage due to an auto accident to receive marihuana as medication.
SB 377 - will dismiss the privacy aspect of the Medical Marihuana Act, and allow the names of patients to be distributed to law enforcement agencies.
SB 418 this bill will make it impossible to sue or create a private cause of action against the State or a political subdivision of this State.
SB 504 this will establish a buffer whereby a person can be prosecuted if they conduct a transfer of marihuana within 1,000 feet from a clearly identified house of worship or school, other than a home school, unless the transfer occurs inside the residence of a qualifying patient who has been issued and possesses a registry identification card.
SB 505 the 2008 law disallows a person with drug related felonies from being a caregiver, this bill would disallow persons with any type of felony from being a caregiver.
SB 506 defines a bona fide physician/patient relationship
House Bill 4850 makes it illegal for patients to acquire or transfer marihuana.
H B 4854 will make it illegal for a caregiver to advertise for or to patients; or of the availability of marihuana.
What are your opinions of the purposed changes?
If there are to be changes, should they be made by legislators or the voters? Why?
Share This Entry:
