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Question 1 of 20
What is your name?
Name*
First Last

Nice to meet you, !

Question 2 of 20
What’s your email address?
Email

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Question 3 of 20
Do you currently use CBD from cannabis, CBD from hemp, or cannabis without CBD?
Do you currently use CBD?
- CBD from cannabis
- CBD from hemp
- CBD from hemp (less than 0.3% THC)
- Cannabis without CBD
- Both cannabis and hemp
- I'm not sure

Question 4 of 20
How long have you been using CBD?
How long have you been using CBD?
- I don't use it
- Less than 30 days
- Between 1 and 6 months
- 6 Months to a year
- 1 to 3 years
- Over 3 years

Question 5 of 20
How often do you typically take CBD?
How often do you typically take CBD?
- Once per day
- Multiple times per day
- Once per week
- Multiple times per week
- Once per month
- Less than once per month
How many milligrams per dose?
- 10mg or less
- 25mg - 50mg
- 100mg or more

Question 6 of 20
Which CBD brands have you used?
Select all that apply
Which CBD brands have you used?
- Smoking (joint, pipe, bong)
- Vape (vaporizer, vape pen and cartridge)
- Ingesting in food or beverage
- Ingesting in pill or capsule
- Sublingually (tincture, drops, spray)
- Topically (cream, ointment, balm, lotion)
- Other

Question 7 of 20
Tell us what condition(s) you currently live with
Select all that apply
Conditions
- Alcoholism / addiction
- ADD or ADHD
- Alzheimer's Disease
- Autism Spectrum Disorder
- Brain injury (e.g. stroke, TBI, tumor)
- Cancer
- Diabetes
- Epilepsy/seizures
- Gastrointestinal disease (e.g. Colitis, Crohn's, IBS)
- Depression, anxiety or other mood disorders
- Motion sickness
- Parkinson's Disease
- Hormonal condition (e.g. PMS, menopause)
- Multiple Sclerosis
- PTSD
- Sleep problems
- Other

Question 8 of 20
How does CBD affect pain in your life?
How does CBD affect pain in your life?
- Much better
- Little better
- No change
- Little worse
- Alot worse
- Not applicable

Question 9 of 20
How does CBD affect your mood?
How does CBD affect your mood?
- Much better
- Little better
- No change
- Little worse
- Alot worse
- Not applicable

Question 10 of 20
How does CBD affect your sleep?
How does CBD affect your sleep?
- Much better
- Little better
- No change
- Little worse
- Alot worse
- Not applicable

Question 11 of 20
How does CBD affect your physical function?
How does CBD affect your physical function?
- Much better
- Little better
- No change
- Little worse
- Alot worse
- Not applicable

Question 12 of 20
How does CBD affect your energy & motivation?
How does CBD affect your energy & motivation?
- Much better
- Little better
- No change
- Little worse
- Alot worse
- Not applicable

Question 13 of 20
How does CBD affect your ability to socialize?
How does CBD affect your ability to socialize?
- Much better
- Little better
- No change
- Little worse
- Alot worse
- Not applicable

Question 14 of 20
Have you experienced any of the following adverse side effects after using CBD?
Select all that apply
Side Effects
- Digestive upset
- Anxiety
- Increased pulse and heart rate
- Distorted perceptions
- Overeating
- Headaches/dizziness
- Impaired coordination
- Increased sensitivity
- Tiredness
- Bloodshot or dry eyes
- Dry mouth
- Impaired concentration
- Other

Question 15 of 20
What is your age?
Age
- Under 18
- 18-24
- 25-34
- 35-44
- 45-54
- 55-64
- 65+

Question 16 of 20
Which gender do you most identify with?
Gender
- Male
- Female
- Gender non-conforming
- Trans-male
- Trans-female
- Prefer not to say

Question 17 of 20
What is your Ethnicity?
What is your Ethnicity?
- White Hispanic or Latino
- Black or African American
- Native American or American Indian
- Asian / Pacific Islander
- Other
- Prefer not to say

Question 18 of 20
What is your highest level of Education
Education
- N/A
- Elementary
- Some high school, no diploma
- High school graduate, diploma or the equivalent
- Some college, no degree
- Trade/technical training
- Associates degree
- Bachelors degree
- Masters degree
- Doctorate degree

Question 19 of 20
Where are you located
Location
- United States
- Outside the US

Question 20 of 20
Thank you for sharing your experiences with us!
Is there anything else you would like to share?
Want to join the CBD Products newsletter?
- Yes! Add me to the list!

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Cannabinoid Balance
About CBD Products
Resources

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