The following form is for consumers who have purchased the AeroInhaler
Where did you purchase your AeroInhaler (dispensary name)?
Approximate date of purchase:
Is there a Batch Number on your AeroInhaler?
YesNoI don't know
If available, what is the Batch Number?
Your age range:
Preferred form(s) of cannabis:
First time using the AeroInhaler?
Where do you reside?
ColoradoOther StateOther Country
Please tell us about your AeroInhaler experience?
May we contact you?
EmailPhoneSMS-TextNo (to ALL)
If you replied yes to "Email or SMS" above, we'd like to send you coupon.
Phone Number (SMS/Text):