postableme
09-08-2010, 11:41 PM
Since I typed up and posted this on another forum this morning, I thought I'd share it here, too, in case anybody found a need for it. :)
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Medical Marijuana Strain Evaluation Form
From Treating Yourself Magazine
Strain:
Breeder:
Grower:
Date:
Physical Examination
1. Visual Appeal, rate 1 (low) to 10 (high): 1 2 3 4 5 6 7 8 9 10
2. Visible Trichomes, 1 (none) to 10 (totally covered): 1 2 3 4 5 6 7 8 9 10
3. Colors present in trichome heads under magnification:
Clear ___ Cloudy ___ Amber ___ Dark ___
4. Colors present in buds, on 1-9 scale light to dark:
Brown ___ Green ___ Gold ___ Blue ___ Grey ___ Red ___
Rust ___ Orange ___ Purple ___ Black ___
5. Bud density, 1 to 10 (airy-dense): 1 2 3 4 5 6 7 8 9 10
6. Aroma descriptors, 1 to 9 on freshly broken bud (suble to pronounced):
Ammonia ___ Earthy ___ Licorice ___ Peach ___ Berry ___
Floral ___ Mango ___ Pepper ___ Blueberry ___ Fruit ___
Meat ___ Petroleum ___ Bubblegum ___ Grape ___ Melon ___
Pine ___ Cedar ___ Grapefruit ___ Menthol ___
7. Aroma, 1 to 10 (repulsive-delightful): 1 2 3 4 5 6 7 8 9 10
8. Seed content, 0-10 (none-fully seeded): 1 2 3 4 5 6 7 8 9 10
9. Weeks cured, if known:
Physical Examination Comments:
Usage
1. Utensils and method consumed:
2. Taste descriptors 1 to 9 (suble-pronounced):
Ammonia ___ Earthy ___ Licorice ___ Peach ___ Berry ___
Floral ___ Mango ___ Pepper ___ Blueberry ___ Fruit ___
Meat ___ Petroleum ___ Bubblegum ___ Grape ___ Melon ___
Pine ___ Cedar ___ Grapefruit ___ Menthol ___ Pineapple ___
Cherry ___ Grass/Hay ___ Mint ___ Rotten ___ Chocolate ___
Hash ___ Mold ___ Skunk ___ Citrus ___ Iron/Rust ___ Musk ___
Spice ___ Coconut ___ Leather ___ Nutmeg ___ Strawberry ___
Coffee ___ Lemon ___ Orange ___ Vanilla ___
3. Taste, 1 to 10 unpleasant-delicious: 1 2 3 4 5 6 7 8 9 10
4. State of dryness 1 to 10 (wet-dry) where 5 is ideal: 1 2 3 4 5 6 7 8 9 10
5. Smoke-ability, 1 to 10 (harsh-smooth), if applicable: 1 2 3 4 5 6 7 8 9 10
6. Smoke expansion, 1 to 10 (stable to explodes): 1 2 3 4 5 6 7 8 9 10
Usage Comments:
Follow-up Questions
1. Dosage to reach desired effect:
2. Effect onset, 1 to 10 (immediate-major creeper): 1 2 3 4 5 6 7 8 9 10
3. Sativa influence, 1-10 (head effect none to extreme): 1 2 3 4 5 6 7 8 9 10
4. Indica influence, 1-10 (body effect none to extreme): 1 2 3 4 5 6 7 8 9 10
5. Potency, 1-10 (none-devastating); 1 2 3 4 5 6 7 8 9 10
6. Duration of effect:
7. Tolerance build up, 1-10: 1 2 3 4 5 6 7 8 9 10
8. Usability, 1-9 (1 undesirable time to use, to 9 desirable time to use):
Morning/wake up 1 2 3 4 5 6 7 8 9
Day/work 1 2 3 4 5 6 7 8 9
Evening/relax 1 2 3 4 5 6 7 8 9
Night/sleep 1 2 3 4 5 6 7 8 9
9. Overall satisfaction, 1-10: 1 2 3 4 5 6 7 8 9 10
10. Ability and conditions (rate your own ability to judge): 1 2 3 4 5 6 7 8 9 10
11. Do you personally consider this strain a keeper for long term use? Y N
12. What effect did the strain have? Write "P" if positive and "N" if negative.
_____ Ability to rest or sit still
_____ Anxiety relief
_____ Appetite
_____ Audio perception
_____ Humor perception
_____ Imagination/creativity
_____ Pain relief
_____ Paranoia relief
_____ Sex drive
_____ Sleep
_____ Speech process
_____ Taste perception
_____ Thought process
_____ Visual perception
Extended Medical Survey, "P" for positive, otherwise leave blank:
_____ ADD/ADHD
_____ Allergic rhinitis
_____ Amphetamine dependence
_____ Anorexia
_____ Arthritis/musculoskeletar pain
_____ Asthma/cough
_____ Bipolar disorder
_____ Cancer/Chemotherapy
_____ Chronic fatigue
_____ Crohn's/IBS
_____ Depression
_____ Diarrhea
_____ Epilepsy
_____ Glaucoma
_____ Hepatitis
_____ High blood pressure/racing pulse
_____ Insomnia
_____ Itching
_____ Migraine/vascular headache
_____ Muscle Spasm
_____ Muscular movement disorders
_____ Nausea
_____ Panic Attack
_____ Peripheral nerve pain
_____ Post traumatic stress disorder
_____ Sedative/opiate dependence
_____ Schizophrenia
_____ Spasticity in multiple sclerosis
----------------------------------
Medical Marijuana Strain Evaluation Form
From Treating Yourself Magazine
Strain:
Breeder:
Grower:
Date:
Physical Examination
1. Visual Appeal, rate 1 (low) to 10 (high): 1 2 3 4 5 6 7 8 9 10
2. Visible Trichomes, 1 (none) to 10 (totally covered): 1 2 3 4 5 6 7 8 9 10
3. Colors present in trichome heads under magnification:
Clear ___ Cloudy ___ Amber ___ Dark ___
4. Colors present in buds, on 1-9 scale light to dark:
Brown ___ Green ___ Gold ___ Blue ___ Grey ___ Red ___
Rust ___ Orange ___ Purple ___ Black ___
5. Bud density, 1 to 10 (airy-dense): 1 2 3 4 5 6 7 8 9 10
6. Aroma descriptors, 1 to 9 on freshly broken bud (suble to pronounced):
Ammonia ___ Earthy ___ Licorice ___ Peach ___ Berry ___
Floral ___ Mango ___ Pepper ___ Blueberry ___ Fruit ___
Meat ___ Petroleum ___ Bubblegum ___ Grape ___ Melon ___
Pine ___ Cedar ___ Grapefruit ___ Menthol ___
7. Aroma, 1 to 10 (repulsive-delightful): 1 2 3 4 5 6 7 8 9 10
8. Seed content, 0-10 (none-fully seeded): 1 2 3 4 5 6 7 8 9 10
9. Weeks cured, if known:
Physical Examination Comments:
Usage
1. Utensils and method consumed:
2. Taste descriptors 1 to 9 (suble-pronounced):
Ammonia ___ Earthy ___ Licorice ___ Peach ___ Berry ___
Floral ___ Mango ___ Pepper ___ Blueberry ___ Fruit ___
Meat ___ Petroleum ___ Bubblegum ___ Grape ___ Melon ___
Pine ___ Cedar ___ Grapefruit ___ Menthol ___ Pineapple ___
Cherry ___ Grass/Hay ___ Mint ___ Rotten ___ Chocolate ___
Hash ___ Mold ___ Skunk ___ Citrus ___ Iron/Rust ___ Musk ___
Spice ___ Coconut ___ Leather ___ Nutmeg ___ Strawberry ___
Coffee ___ Lemon ___ Orange ___ Vanilla ___
3. Taste, 1 to 10 unpleasant-delicious: 1 2 3 4 5 6 7 8 9 10
4. State of dryness 1 to 10 (wet-dry) where 5 is ideal: 1 2 3 4 5 6 7 8 9 10
5. Smoke-ability, 1 to 10 (harsh-smooth), if applicable: 1 2 3 4 5 6 7 8 9 10
6. Smoke expansion, 1 to 10 (stable to explodes): 1 2 3 4 5 6 7 8 9 10
Usage Comments:
Follow-up Questions
1. Dosage to reach desired effect:
2. Effect onset, 1 to 10 (immediate-major creeper): 1 2 3 4 5 6 7 8 9 10
3. Sativa influence, 1-10 (head effect none to extreme): 1 2 3 4 5 6 7 8 9 10
4. Indica influence, 1-10 (body effect none to extreme): 1 2 3 4 5 6 7 8 9 10
5. Potency, 1-10 (none-devastating); 1 2 3 4 5 6 7 8 9 10
6. Duration of effect:
7. Tolerance build up, 1-10: 1 2 3 4 5 6 7 8 9 10
8. Usability, 1-9 (1 undesirable time to use, to 9 desirable time to use):
Morning/wake up 1 2 3 4 5 6 7 8 9
Day/work 1 2 3 4 5 6 7 8 9
Evening/relax 1 2 3 4 5 6 7 8 9
Night/sleep 1 2 3 4 5 6 7 8 9
9. Overall satisfaction, 1-10: 1 2 3 4 5 6 7 8 9 10
10. Ability and conditions (rate your own ability to judge): 1 2 3 4 5 6 7 8 9 10
11. Do you personally consider this strain a keeper for long term use? Y N
12. What effect did the strain have? Write "P" if positive and "N" if negative.
_____ Ability to rest or sit still
_____ Anxiety relief
_____ Appetite
_____ Audio perception
_____ Humor perception
_____ Imagination/creativity
_____ Pain relief
_____ Paranoia relief
_____ Sex drive
_____ Sleep
_____ Speech process
_____ Taste perception
_____ Thought process
_____ Visual perception
Extended Medical Survey, "P" for positive, otherwise leave blank:
_____ ADD/ADHD
_____ Allergic rhinitis
_____ Amphetamine dependence
_____ Anorexia
_____ Arthritis/musculoskeletar pain
_____ Asthma/cough
_____ Bipolar disorder
_____ Cancer/Chemotherapy
_____ Chronic fatigue
_____ Crohn's/IBS
_____ Depression
_____ Diarrhea
_____ Epilepsy
_____ Glaucoma
_____ Hepatitis
_____ High blood pressure/racing pulse
_____ Insomnia
_____ Itching
_____ Migraine/vascular headache
_____ Muscle Spasm
_____ Muscular movement disorders
_____ Nausea
_____ Panic Attack
_____ Peripheral nerve pain
_____ Post traumatic stress disorder
_____ Sedative/opiate dependence
_____ Schizophrenia
_____ Spasticity in multiple sclerosis