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Medical Marijuana Survey

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Medical Marijuana Survey

MAHALO FOR JOINING! PLEASE KNOW THAT PEACEFUL SKY ALLIANCE WILL NEVER SHARE YOUR NAME OR INFORMATION WITH ANY OTHER GROUP WITHOUT YOUR PERMISSION. YOUR PRIVACY IS OF UTMOST IMPORTANCE TO US.

Your Name (required)

Your Email (required)

Are you registered as a medical marijuana user?
 Yes No

Are there other members of your household registered as medical marijuana users?
 Yes No

If yes, how many?

How long have you been a registered medical marijuana user?

Have you ever been visited by the police?
 Yes No

Dates (approximate or exact of when this occurred)

Was a search warrant shown?
 Yes No

Was your premises searched?
 Yes No

Did anything occur that was a compromise of your security?
 Yes No

Were you visited by anyone who seemed to have information about your plants?
 Yes No

Were any plants taken?
 Yes No

Is your license current?
 Yes No

Do you plan on renewing it?
 Yes No

We seek to advocate on behalf of members. We would only do so if we had your consent. May we contact you regarding your concerns?
 Yes No

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