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Smoke Report Template


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IDENTIFICATION

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Date:

Strain:

Reviewer:

Breeder:

Grower:

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PHYSICAL EXAMINATION

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1. [ ] Visual Appeal:Rate the visual appeal of the buds from 1-10 unappealing-excellent.

2. [ ]Bud density: Rate the bud density from 1-10 airy-dense. For samples that are not in

their natural state leave this field blank.

3. [ ]Aroma Rate the aroma from 1-10 repulsive-delightful. Use freshly crumbled bud for

best results.

4. [ ]Seed content Rate seed content from 0-10 none-fully seeded.

5. [ ]Weeks cured If known enter the number of weeks your sample has been cured.

6. Use numbers 1-9 on descriptors that apply to the aroma of freshly broken bud where a

one indicates a subtle presence and 9 indicates a pronounced presence. Delete the existing

space when marking a descriptor in order to maintain the columns in alignment.

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 [ ]

 

PHYSICAL EXAMINATION COMMENTS:

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THE SMOKE TEST

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Address these questions while smoking.

 

1. [ ]Enter instrument used to smoke(eg: papers, bong, vaporizer)

2. [ ]Taste: Rate your impression of the taste from 1-10 unpleasant-delicious.

3. [ ]State of dryness: Rate the dryness of the bud from 1-10 wet-dry where 5 is ideal.

4. [ ]Smoke ability: Rate the smoke ability of the sample from 1-10 harsh-smooth.

5. [ ]Smoke expansion: Rate how the smoke expands in the lungs from 1-10 stable-explodes.

6. Use numbers 1-9 on descriptors that apply to the taste where a one indicates a subtle

presence and a nine indicates a very pronounced presence. Delete the existing space when

marking a descriptor in order to maintain the columns in alignment.

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 [ ]

 

SMOKE TEST COMMENTS:

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FOLLOW UP QUESTIONS

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Address final questions immediately after effects have worn off.

 

1. [ ]Dosage: Enter the number of hits taken to reach desired effects.

2. [ ]Effect onset: Rate how quickly the effect hit from 1-10 immediate-major creeper.

3. [ ]Sativa influence: Rate the sativa influence detected from 0-10 none-extreme. Sativa

influence is best described as a clear and energetic mental effect.

4. [ ]Indica influence: Rate the indica influence detected from 0-10 none-extreme. Indica

influence is best described as a sedative, lethargic or numbing effect that affects the body.

5. [ ]Potency: Rate the potency of the sample from 0-10 none-devastating.

6. [ ]Duration: Indicate the number of hours the effects lasted.

7. [ ]Tolerance build up: Rate how quickly tolerance builds from 0-10 none-rapid. Leave

this field blank if you have not used this sample repeatedly.

8. [ ]Overall satisfaction: Rate your overall satisfaction from 1-10 poor-Holy Grail.

9.Judging from the sample alone do you personally consider this

strain a keeper for long term use. Yes [ ] No [ ]

 

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MEDICAL SURVEY

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Rate the noticable effects on a scale of 1-9 mild-severe. Take care to use the

appropriate column for your response. Delete the existing space when recording your

entry to maintain the columns in alignment. In all cases these casual observations should

not be construed as medical advice.

What effect did the strain have check [P] off if the you got a POSITIVE EFFECT and

check [N] if you had a NEGATIVE EFFECT

 

[P] [N] Ability to rest or sit still

[P] [N] Anxiety relief

[P] [N] Appetite

[P] [N] Audio perception

[P] [N] Humor perception

[P] [N] Imagination/creativity

[P] [N] Paranoia relief

[P] [N] Sex drive

[P] [N] Sleep

[P] [N] Pain relief

[P] [N] Speech process

[P] [N] Taste perception

[P] [N] Thought process

[P] [N] Visual perception

 

EXTENDED MEDICAL SURVEY (optional)

What effect did the strain have check [P] off if the you got a POSITIVE EFFECT and

check [N] if you had a NEGATIVE EFFECT

[P] [N]ADD/ADHD

[P] [N]Alcoholism/Alcohol Abuse

[P] [N]Allergic rhinitis

[P] [N]Amphetamine Dependence

[P] [N]Anorexia

[P] [N]Arthritis/Musculoskeletar pain

[P] [N]Asthma/Cough

[P] [N]Bipolar disorder

[P] [N]Cancer/Chemotherapy

[P] [N]Chronic fatigue

[P] [N]Depression

[P] [N]Diarrhea

[P] [N]Drusen of Optic Nerve

[P] [N]Epilepsy

[P] [N]Glaucoma

[P] [N]Hiccough

[P] [N]High blood pressure/Racingpulse

[P] [N]Insomnia

[P] [N]Itching

[P] [N]Migraine/vascular headache

__________________

 

 

 

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