Blank SMOKE REPORT form by JastAnotherAntMarching

Hey guys... Spearchucker suggested I send this blank form to a Mod so they could make it a Sticky....

But I figured why not just post it for all and if enough people like it, use it, then maybe they will consider it for a Sticky...?

So its up to you folks out there.... It doesnt take long and does require you to smoke some weed...

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IDENTIFICATION
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Date:
Strain:
Judge:
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. Visible Trichomes: Rate the visible trichome content from 1-10 none-totally covered.

3. Use an X to indicate the colors that are present in the trichome heads under magnification or list the percentages of each color for a more precise report.

Clear [ ] Cloudy [ ] Amber [ ] Dark [ ]

4. Mark with X the colors that are present in the buds or for a more detailed color analysis rate presence on a scale 1-9 light-dark.

Brown [ ] Green [ ] Gold [ ] Blue [ ] Grey [ ] White [ ] Red [ ] Rust [ ] Orange [ ] Purple [ ] Black [ ]

5. Bud density: [ ] Rate the bud density from 1-10 airy-dense. For samples that are not in their natural state leave this field blank.

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 [ ]

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

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

9. Weeks cured [ ] If known enter the number of weeks your sample has been cured. If desired repeat SSR after an additional two weeks of curing.

PHYSICAL EXAMINATION COMMENTS:
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THE SMOKE TEST
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Address these questions while smoking.

1. Please use a clean instrument for the evaluation. Enter information below that will identify the instrument as follows:

Water pipe (enter bong, hooka, bubbler etc) [ ]
Vaporizer (enter the brand name) [ ]
Pipe (size-type, ie medium-glass) [ ]
Joint (enter brand of papers) [ ]
Other (specify):

2. 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 [ ]

If appropriate return to this question after 5-10 minutes and mark
with X any unmarked descriptors for lingering aftertaste.

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

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

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

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

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. Usability [ ] Rate on a scale of 1-9 where a one indicates the worst time of day to consume this strain and a nine represents the ideal time of day. Leave field(s) blank if you have not yet formed an opinion.

Morning - wake up [ ] Day - work [ ] Evening - relax [ ] Night - sleep [ ]

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

10.Ability and conditions [ ] Rate your overall ability to judge from 1-10 low-high. Consider experience, strain familiarity, atmosphere, current tolerance and most importantly the condition and preparation of the sample.

11.Judging from the sample alone do you personally consider this
strain a keeper for long term use. Yes [ ] No [ ]

12.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]Ankylosing Spondylitis
[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]Crohn's/IBS
[P] [N]Depression
[P] [N]Diarrhea
[P] [N]Drusen of Optic Nerve
[P] [N]Epilepsy
[P] [N]Glaucoma
[P} [N]Hepatitis
[P] [N]Hiccough
[P] [N]High blood pressure/Racingpulse
[P] [N]Insomnia
[P] [N]Itching
[P] [N]Migraine/vascular headache
[P] [N]Muscle Spasm
[P] [N]Muscular movement disorders
[P] [N]Nausea
[P] [N]Panic Attack
[P] [N]Peripheral nerve pain
[P] [N]Post traumatic Stress Disorder
[P] [N]Pre Menstrual Syndrome
[P] [N]Sedative/Opiate Dependence
[P] [N]Schizophrenia
[P] [N]SLE - systemic lupus erythematosus
[P] [N]Spasticity in Multiple Sclerosis

FINAL COMMENTS: