Welcome to the KOLPIN health and fitness questionnaire!
Please take a few minutes and answer the questions below so I may better serve your personal nutritional needs.

Thank you!
Kyle Kolpin

    What are your fitness and nutritional goals? (check all that apply)

    What motivates you?

    Do you currently exercise?

    What activities do you currently take part in?

    Do you smoke?

    Do you drink?

    What’s your eating style? (check all that apply)

    Do you regularly have any of the following from eating?

    Indicate all that apply to your current nutrition:

    Typically, how many hours do you sleep each night (on average)

    Is there any medical or surgical history that I should be aware of prior to writing this program? If so, please list below.