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If you are a returning patient to marijuana doctor?*
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Yes
Cell phone
What local Medical Marijuana Treatment Center (dispensary) are you ordering from?
Are you currently on probation?*
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Yes
Are you currently pregnant?
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Are you planning on getting pregnant?
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Please select any of the following problems you have or have experienced since your last visit*
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Medical Marijuana Treatment, please provide details is your current dosage and regimen effective for your medical condition?*
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What would you describe your current usage as?
What side effects, if any, have you experienced due to marijuana treatment?
Are you experiencing any benefits from using Medical Marijuana compare to your previously medical treatment?*
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Have experienced an adverse drug interaction with any prescription or nonprescription medication with medical marijuana?*
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