First Name* Last Name* E-mail Address* Birth Date* Mobile Number* WhatsApp number Instagram Facebook What medical condition/s would you like treated with Cannabis?* What type/s of Cannabis products help with your medical condition/s?Flower (Bud)EdiblesConcentratesPersonal CareWhat type of experience do you prefer?Energizing & UpliftingCalming & RelaxingBoth, depends on mood and/or time of dayHow often do you consume Cannabis products?DailyWeeklyMonthlyA few times a yearOnly on special occasionsHow many grams of flower do you consume a month?1 - 55 - 1010 - 2020 - 3030+I don't consume flowerWhat are your preferred edibles?Baked GoodsChocolateSugar SweetsInfused FoodsWhat is your maximum comfortable edible dosage?5 - 15 mg15 - 30mg30 - 60 mg60 - 100 mg100+ mg Only fill in if you are not human
