The following form is for consumers who have purchased the AeroInhaler
Your Name:
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: 21-3031-4041-5050+
Preferred form(s) of cannabis: AeroInhalerSublingualDabbingVapingFlowerEdiblesOther
First time using the AeroInhaler? YesNo
Where do you reside? ColoradoOther StateOther Country
Please tell us about your AeroInhaler experience? Type Here
May we contact you? EmailPhoneSMS-TextNo (to ALL)
If you replied yes to "Email or SMS" above, we'd like to send you coupon. YesNo
Email Address:
Phone Number (SMS/Text):
