Cholesterol Research Survey
This survey should take about 3-5 minutes to fill out. You will need the most recent cholesterol test you've taken, and the last one taken before you began your current diet.
What diet do you follow? *
About when did you begin this diet? *
MM
/
DD
/
YYYY
The following applies to your most recent cholesterol test while on the diet...
When was this test taken? *
MM
/
DD
/
YYYY
Were you water-only fasted for 12-14 hours before the cholesterol test? If not, write in how long. *
Total Cholesterol: *
Your answer
LDL Cholesterol (LDL-C): *
Your answer
HDL Cholesterol (HDL-C) *
Your answer
Triglycerides (TG) *
Your answer
The following applies to the last cholesterol test you had before the diet...
When was this test taken? *
MM
/
DD
/
YYYY
Were you water-only fasted for 12-14 hours before the cholesterol test? If not, write in how long. *
Total Cholesterol: *
Your answer
LDL Cholesterol (LDL-C): *
Your answer
HDL Cholesterol (HDL-C) *
Your answer
Triglycerides (TG) *
Your answer
The following is for internal records of the CholesterolCode team only and will not be distributed in any way without your consent...
What is your first name? *
Your answer
What is your last name? *
Your answer
What is your email address? *
Your answer
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