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Mima Remedies Survey
As part of the 2018 Farm Bill, Mima Remedies is required to report market research on industrial hemp and CBD. This is a great opportunity for us to bring more insight into consumer relationships with CBD. The last section of the survey is a chance for you to share your CBD story. Thanks for your participation and please share with family and friends.
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Name (optional)
Your answer
Email (optional)
Your answer
I would like my email to be
Used for 10% off my order
Added to mima remedies' mailing list
How old are you?
0-18 years old
18-29 years old
30-45 years old
46-60 years old
61-75 years old
76+ years old
Clear selection
What is your gender identity?
Man
Woman
Non-binary/Third gender
Prefer not to say
Other:
Clear selection
Where did you first hear about CBD?
Friend or Relative
Medical Professional
Internet
Television
Newspaper
Radio
Other:
Clear selection
Which conditions do you use CBD for? Select any and all that apply.
Acne/skin condition
Addiction
ALS
Alzheimer's
Anxiety
Arthritis
Autism
Cancer
Crohn's Disease
Depression
Endocrine Disorders
Glaucoma
Heart Disease
Huntington's Disease
Inflammation
Kidney Disease
Liver Disease
Metabolic Syndrome
Migraines
Mood disorders
Multiple Sclerosis
Nausea
Neurodegeneration
Neuropathic pain
Parkinson's Disease
Prion toxicity
Post Traumatic Stress Disorder
Rheumatism
Schizophrenia
Sickle Cell Anemia
Sleep disorder
Spinal Cord injury
Stress
Stroke/TBI
None of these
Other:
What is your preferred method of use? Select any and all that apply.
Smoking
Vaporization
Ingestion
Sublingual (under the tongue)
Topical
Suppository
n/a
Other:
Please describe in more detail your preferred method of use (e.g. adding CBD to a beverage, rubbing on effected area, vaporizing in a cartridge). If this does not apply to you, write n/a.
Your answer
How long ago did you first use CBD?
Less than a month
1-3 months
3-6 months
6 months - 1 year
Over 1 year
n/a
Clear selection
How many times in the last month did you use CBD?
Multiple times a day
Once a day
Every other day
Once a week
1-3 times in the last month
Not at all
Clear selection
When you use CBD, how many milligrams do you take?
<5 mg
5-10 mg
10-25 mg
25-50 mg
50-100 mg
>100 mg
I don't know
n/a
Clear selection
Do you use CBD isolate (100% CBD) or full spectrum products? (flower is full spectrum)
Isolate
Full spectrum
I don't know
n/a
Clear selection
Where do you source your CBD? Select all that apply.
Gas station/Convenience store
Grocery store
Supplement store
Tobacco/smoke shop
Online
Dispensary
Friend or Relative
n/a
Other:
What brand and product do you use? If this does not apply to you, write n/a.
Your answer
Select the following terms you are familiar with:
CBD
THC
Cannabinoid
Terpene
Flavonoid
Endocannabinoid system
Entourage effect
CBG
Industrial hemp
None of these
In the last 3 months, how often did you use THC?
Never
1 or more times
Prefer not to answer
Clear selection
People have described the following effects of CBD. Select any and all that apply to you.
Relief from anxiety
Calming
Body relaxation
Mental clarity
Helps me sleep
Pain relief - general
Pain relief - acute
Pain relief - chronic
Energizing
Nausea relief
Joint pain relief
None of these
Other:
Do you use any prescription medications? Please select all that apply.
Antidepressants
Anti-anxiety
Heart medication
Cancer medication
Opiate pain killers
Insulin
Anti seizure medication
Medical marijuana
Medication to treat tremors/muscle spasms
Sleep medication
None
Prefer not to answer
Other:
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