COVID-19 Cannabis Health Questionnaire

1. Do you have a chronic health condition?
   1. Yes
   2. No
      
      
2. Which of the following do you currently live with?

        Asthma                              Heart Disease                Lupus

        Respiratory Disease             Cancer                         Obesity

        Autoimmune Disease            HIV/AIDS                     Other

        High Blood Pressure              Anxiety

        Diabetes                              Depression

3. If other, please list __________________________
   
   
4. Do you use cannabis to treat a chronic health condition?
   1. Yes
   2. No
      
      
5. Does your health insurance cover your medical cannabis?
   1. Yes
   2. No
   3. I don’t have health insurance
      
      
6. What is the dominant cannabinoid (i.e., THC, CBD, CBN) within your medical cannabis?
   1. CBD dominant
   2. THC dominant
   3. CBD and THC ratio
   4. Other cannabinoid dominant
   5. Unsure
      
      
7. Since COVID-19 has been declared a pandemic, are you (or were you) worried about not being able to pay for your cannabis?
   1. Yes
   2. No
      
      
8. Since COVID-19 has been declared a pandemic, did a health professional recommend you use cannabis to manage COVID-19 or the coronavirus?
   1. Yes
   2. No
      
      
9. Since COVID-19 has been declared a pandemic, did a health professional recommend you get an advanced supply of your cannabis?
   1. Yes
   2. No
      
      
10. Since COVID-19 has been declared a pandemic, have you gotten an advanced supply of your cannabis?
    1. Yes
    2. No
       
       
11. How long will the advanced supply of cannabis last you?
    1. 1 week
    2. 2 weeks
    3. 3 weeks
    4. 1 month
    5. 2 months
    6. 3 months
    7. More than 3 months
       
       
12. Since COVID-19 has been declared a pandemic, how has the dose of your cannabis use changed?
    1. The amount used has increased
    2. The amount used has decreased
    3. The amount used has stayed the same
       
       
13. How often were you under the influence of psychoactive cannabis for 6 or more hours?
    1. Never
    2. Less than Monthly
    3. Monthly
    4. Weekly
    5. Daily/Almost Daily

14. Since COVID-19 has been declared a pandemic, has the method you use cannabis changed? (i.e., smoke, pill, tincture, etc.)
    1. Yes
    2. No
       
       
15. Before COVID-19 has been declared a pandemic, which method of delivery do you use the most?

 Smoked it in a pipe/bowl                             Vaporizer

 Smoked it in a blunt                                    Ointment, cream, patch

 Smoked it in a joint                                     Tincture

 Edible (in food or drink)                               Pill

16. Since COVID-19 has been declared a pandemic, which method of delivery do you use the most?

 Smoked it in a pipe/bowl                             Vaporizer

 Smoked it in a blunt                                    Ointment, cream, patch

 Smoked it in a joint                                     Tincture

 Edible (in food or drink)                              Pill

17. Since COVID-19 has been declared a pandemic, do you share joints, blunts, or spliffs?
    1. Yes
    2. No
       
       
18. Since COVID-19 has been declared a pandemic, do you share electronic vaporizing devices?
    1. Yes
    2. No
       
       
19. Have you had any pain in your throat, chest, or lungs after using cannabis?
    1. Yes
    2. No
       
       
20. Do you currently have COVID-19 symptoms?
    1. Yes
    2. No
       
       
21. If yes, select all that apply.
    1. Runny nose
    2. Sore throat
    3. Cough
    4. Fever
    5. Difficulty breathing
       
       
22. Have you been tested for COVID-19?
    1. Yes
    2. No
       
       
23. Have you tested positive for COVID-19?
    1. Yes
    2. No
       
       
24. Do you fear giving COVID-19 to someone else?
    1. Yes
    2. No
       
       
25. Do you fear being diagnosed with COVID-19?
    1. Yes
    2. No
       
       
26. Have you isolated yourself from other due to COVID-19?
    1. Yes
    2. No
       
       
27. How are you coping with the COVID-19 pandemic?