Medical Cannabis Discrimination Survey This anonymous survey is being conducted by California NORML. To participate, you must be a medical cannabis patient in California. For questions, write info@canorml.org. OK Question Title * 1. What is your age? 18 to 24 25 to 34 35 to 44 45 to 54 55 to 64 65 to 74 75 or older OK Question Title * 2. What is your zip code? OK Question Title * 3. Have you been denied employment because you tested positive for marijuana? Yes No Maybe/Unsure You may enter a description of your experience. OK Question Title * 4. Have you been terminated from a job because you tested positive for marijuana? Yes No Maybe/Unsure You may enter a description of your experience. OK Question Title * 5. Are you looking for a job and afraid of losing an employment opportunity because you use cannabis/marijuana? Yes No Maybe/Unsure You may add comments. OK Question Title * 6. Have you been denied prescription drugs, including painkillers, because you tested positive for cannabis use? Yes No Maybe/Unsure You may add a brief description of your experience. OK Question Title * 7. Have you stopped using cannabis because of drug testing by your doctor or employer? Yes No Maybe/Unsure You may add a description of your experience. OK Question Title * 8. Have you increased your use of opioid or other medications because of drug testing for cannabis by your doctor or employer? Yes No Maybe/Unsure You may add a comment about your experience. Please specify which medications (e.g. opioids, anxiety or sleep medications, or NSAIDS such as ibuprofen and naproxen). OK Question Title * 9. Would you be willing to speak publicly or to your elected representatives about your situation? IF YOU ANSWER "YES", PLEASE BE SURE TO PROVIDE CONTACT INFORMATION AT THE NEXT QUESTION SO THAT WE MAY REACH YOU. Yes No Maybe/Unsure You may add a comment. OK Question Title * 10. (Optional): You may provide contact information to participate in our campaign for patients' rights. your name email address phone number street address city OK DONE