Pain Management Questionnaire

The purpose of your review with Dr Lucas

If your Veterans’ Health clinician is prescribing, or considering prescribing, CBD, THC, or a combination of both, they need a specialist in neurosurgery to review your situation. This helps ensure all treatment options are considered and that the safest, most appropriate plan is chosen for you.

This appointment is that specialist review.

Please complete this brief questionnaire prior to your appointment. This helps Dr Lucas exactly which THC/CBD medications you are currently using.

Name

Type of DVA card held

Gold

White

Pain Management Questionnaire

The purpose of your review with Dr Lucas

Name

Type of DVA card held

Please list all the THC or CBD medications you usually take daily.