{"id":5694,"date":"2021-05-10T11:41:54","date_gmt":"2021-05-10T11:41:54","guid":{"rendered":"https:\/\/allurionkliniek.nl\/lsc-nutrition-questionnaire\/"},"modified":"2023-03-06T21:20:25","modified_gmt":"2023-03-06T21:20:25","slug":"lsc-nutrition-questionnaire","status":"publish","type":"page","link":"https:\/\/allurionkliniek.nl\/en\/lsc-nutrition-questionnaire\/","title":{"rendered":"LSC Nutrition questionnaire"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"5694\" class=\"elementor elementor-5694 elementor-3149\" data-elementor-post-type=\"page\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-5e2d003 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"5e2d003\" data-element_type=\"section\" data-e-type=\"section\" data-settings=\"{&quot;jet_parallax_layout_list&quot;:[]}\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-4c7987b\" data-id=\"4c7987b\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-a63ac76 elementor-widget elementor-widget-heading\" data-id=\"a63ac76\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h1 class=\"elementor-heading-title elementor-size-default\">LSC Nutrition questionnaire<\/h1>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-7106393 elementor-widget elementor-widget-wp-widget-gform_widget\" data-id=\"7106393\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"wp-widget-gform_widget.default\">\n\t\t\t\t<div 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class='gform-body gform_body'><ul id='gform_fields_35' class='gform_fields top_label form_sublabel_below description_above validation_below'><li id=\"field_35_139\" class=\"gfield gfield--type-text field_admin_only field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_administrative\"  ><input name='input_139' id='input_35_139' class='gform_hidden' type='hidden' value=''\/><\/li><li id=\"field_35_2\" class=\"gfield gfield--type-text gf_left_half field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_35_2'><span class='gform-field-label__text'>Marital status \/ Family situation<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_2' id='input_35_2' type='text' value='' class='medium'   tabindex='1'   aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_35_3\" class=\"gfield gfield--type-text gf_right_half field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_35_3'><span class='gform-field-label__text'>Profession<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_3' id='input_35_3' type='text' value='' class='medium'   tabindex='2'   aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_35_108\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><\/br><hr\/><\/br><\/br><\/li><li id=\"field_35_10\" class=\"gfield gfield--type-radio gfield--type-choice gf_list_inline field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Do you have specific questions in the field of lifestyle and diet?<\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_35_10'>\n\t\t\t<li class='gchoice gchoice_35_10_0'>\n\t\t\t\t<input name='input_10' type='radio' value='yes'  id='choice_35_10_0' tabindex='3'   \/>\n\t\t\t\t<label for='choice_35_10_0' id='label_35_10_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_35_10_1'>\n\t\t\t\t<input name='input_10' type='radio' value='no'  id='choice_35_10_1' tabindex='4'   \/>\n\t\t\t\t<label for='choice_35_10_1' id='label_35_10_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_35_5\" class=\"gfield gfield--type-text field_sublabel_below gfield--has-description field_description_above hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_35_5'><span class='gform-field-label__text'>specific_questions_lifestyle_yes<\/span><\/label><div class='gfield_description' id='gfield_description_35_5'>If yes, what are your questions?  <\/div><div class='ginput_container ginput_container_text'><input name='input_5' id='input_35_5' type='text' value='' class='large'  aria-describedby=\"gfield_description_35_5\" tabindex='5'   aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_35_113\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><\/br><\/li><li id=\"field_35_9\" class=\"gfield gfield--type-checkbox gfield--type-choice gf_list_inline field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>What do you think is the relationship between your symptoms and your lifestyle?<\/span><\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_35_9'><li class='gchoice gchoice_35_9_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_9.1' type='checkbox'  value='Unhealthy food'  id='choice_35_9_1' tabindex='6'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_35_9_1' id='label_35_9_1' class='gform-field-label gform-field-label--type-inline'>Unhealthy food<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_35_9_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_9.2' type='checkbox'  value='Eating too much'  id='choice_35_9_2' tabindex='7'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_35_9_2' id='label_35_9_2' class='gform-field-label gform-field-label--type-inline'>Overeating<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_35_9_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_9.3' type='checkbox'  value='Emotion Eating'  id='choice_35_9_3' tabindex='8'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_35_9_3' id='label_35_9_3' class='gform-field-label gform-field-label--type-inline'>Stress eating<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_35_9_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_9.4' type='checkbox'  value='Not enough exercise'  id='choice_35_9_4' tabindex='9'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_35_9_4' id='label_35_9_4' class='gform-field-label gform-field-label--type-inline'>Too little exercise<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_35_9_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_9.5' type='checkbox'  value='Stress'  id='choice_35_9_5' tabindex='10'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_35_9_5' id='label_35_9_5' class='gform-field-label gform-field-label--type-inline'>Stress<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_35_9_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_9.6' type='checkbox'  value='Hereditary'  id='choice_35_9_6' tabindex='11'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_35_9_6' id='label_35_9_6' class='gform-field-label gform-field-label--type-inline'>Genetics<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_35_9_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_9.7' type='checkbox'  value='No idea'  id='choice_35_9_7' tabindex='12'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_35_9_7' id='label_35_9_7' class='gform-field-label gform-field-label--type-inline'>No idea<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_35_8\" class=\"gfield gfield--type-text field_sublabel_below gfield--has-description field_description_above hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label screen-reader-text' for='input_35_8'><span class='gform-field-label__text'>Other:<\/span><\/label><div class='gfield_description' id='gfield_description_35_8'>Other:<\/div><div class='ginput_container ginput_container_text'><input name='input_8' id='input_35_8' type='text' value='' class='large'  aria-describedby=\"gfield_description_35_8\" tabindex='13'   aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_35_142\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><\/br><\/li><li id=\"field_35_7\" class=\"gfield gfield--type-radio gfield--type-choice gf_list_inline field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>5. Are your symptoms periodically dependant?<\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_35_7'>\n\t\t\t<li class='gchoice gchoice_35_7_0'>\n\t\t\t\t<input name='input_7' type='radio' value='again'  id='choice_35_7_0' tabindex='14'   \/>\n\t\t\t\t<label for='choice_35_7_0' id='label_35_7_0' class='gform-field-label gform-field-label--type-inline'>Weather<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_35_7_1'>\n\t\t\t\t<input name='input_7' type='radio' value='season'  id='choice_35_7_1' tabindex='15'   \/>\n\t\t\t\t<label for='choice_35_7_1' id='label_35_7_1' class='gform-field-label gform-field-label--type-inline'>Season<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_35_7_2'>\n\t\t\t\t<input name='input_7' type='radio' value='daily'  id='choice_35_7_2' tabindex='16'   \/>\n\t\t\t\t<label for='choice_35_7_2' id='label_35_7_2' class='gform-field-label gform-field-label--type-inline'>Time of day<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_35_7_3'>\n\t\t\t\t<input name='input_7' type='radio' value='menstruation'  id='choice_35_7_3' tabindex='17'   \/>\n\t\t\t\t<label for='choice_35_7_3' id='label_35_7_3' class='gform-field-label gform-field-label--type-inline'>Menstruation<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_35_11\" class=\"gfield gfield--type-text field_sublabel_below gfield--has-description field_description_above hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label screen-reader-text' for='input_35_11'><span class='gform-field-label__text'>Other:<\/span><\/label><div class='gfield_description' id='gfield_description_35_11'>Other:<\/div><div class='ginput_container ginput_container_text'><input name='input_11' id='input_35_11' type='text' value='' class='large'  aria-describedby=\"gfield_description_35_11\" tabindex='18'   aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_35_114\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><\/br><hr><strong>Questions with regards to dietary habits<\/strong><\/br><\/br><\/li><li id=\"field_35_13\" class=\"gfield gfield--type-radio gfield--type-choice gf_list_inline field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>How much do generally eat?<\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_35_13'>\n\t\t\t<li class='gchoice gchoice_35_13_0'>\n\t\t\t\t<input name='input_13' type='radio' value='very much'  id='choice_35_13_0' tabindex='19'   \/>\n\t\t\t\t<label for='choice_35_13_0' id='label_35_13_0' class='gform-field-label gform-field-label--type-inline'>Very much<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_35_13_1'>\n\t\t\t\t<input name='input_13' type='radio' value='much'  id='choice_35_13_1' tabindex='20'   \/>\n\t\t\t\t<label for='choice_35_13_1' id='label_35_13_1' class='gform-field-label gform-field-label--type-inline'>A lot<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_35_13_2'>\n\t\t\t\t<input name='input_13' type='radio' value='normal'  id='choice_35_13_2' tabindex='21'   \/>\n\t\t\t\t<label for='choice_35_13_2' id='label_35_13_2' class='gform-field-label gform-field-label--type-inline'>Normal<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_35_13_3'>\n\t\t\t\t<input name='input_13' type='radio' value='moderate'  id='choice_35_13_3' tabindex='22'   \/>\n\t\t\t\t<label for='choice_35_13_3' id='label_35_13_3' class='gform-field-label gform-field-label--type-inline'>Little<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_35_13_4'>\n\t\t\t\t<input name='input_13' type='radio' value='few'  id='choice_35_13_4' tabindex='23'   \/>\n\t\t\t\t<label for='choice_35_13_4' id='label_35_13_4' class='gform-field-label gform-field-label--type-inline'>Very little<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_35_16\" class=\"gfield gfield--type-radio gfield--type-choice gf_list_inline field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>What kind of food do you prefer?<\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_35_16'>\n\t\t\t<li class='gchoice gchoice_35_16_0'>\n\t\t\t\t<input name='input_16' type='radio' value='sweet'  id='choice_35_16_0' tabindex='24'   \/>\n\t\t\t\t<label for='choice_35_16_0' id='label_35_16_0' class='gform-field-label gform-field-label--type-inline'>Sweet<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_35_16_1'>\n\t\t\t\t<input name='input_16' type='radio' value='salt'  id='choice_35_16_1' tabindex='25'   \/>\n\t\t\t\t<label for='choice_35_16_1' id='label_35_16_1' class='gform-field-label gform-field-label--type-inline'>Salty<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_35_16_2'>\n\t\t\t\t<input name='input_16' type='radio' value='fat'  id='choice_35_16_2' tabindex='26'   \/>\n\t\t\t\t<label for='choice_35_16_2' id='label_35_16_2' class='gform-field-label gform-field-label--type-inline'>Fatty<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_35_17\" class=\"gfield gfield--type-checkbox gfield--type-choice gf_list_inline field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>What do you eat very regularly?<\/span><\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_35_17'><li class='gchoice gchoice_35_17_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_17.1' type='checkbox'  value='pasta'  id='choice_35_17_1' tabindex='27'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_35_17_1' id='label_35_17_1' class='gform-field-label gform-field-label--type-inline'>Pasta<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_35_17_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_17.2' type='checkbox'  value='rice'  id='choice_35_17_2' tabindex='28'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_35_17_2' id='label_35_17_2' class='gform-field-label gform-field-label--type-inline'>Rice<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_35_17_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_17.3' type='checkbox'  value='potato'  id='choice_35_17_3' tabindex='29'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_35_17_3' id='label_35_17_3' class='gform-field-label gform-field-label--type-inline'>Potatoes<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_35_17_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_17.4' type='checkbox'  value='bread'  id='choice_35_17_4' tabindex='30'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_35_17_4' id='label_35_17_4' class='gform-field-label gform-field-label--type-inline'>Bread<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_35_17_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_17.5' type='checkbox'  value='none of them'  id='choice_35_17_5' tabindex='31'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_35_17_5' id='label_35_17_5' class='gform-field-label gform-field-label--type-inline'>None of the above<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_35_18\" class=\"gfield gfield--type-checkbox gfield--type-choice gf_list_inline field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>What do you usually eat?<\/span><\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_35_18'><li class='gchoice gchoice_35_18_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_18.1' type='checkbox'  value='meat'  id='choice_35_18_1' tabindex='32'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_35_18_1' id='label_35_18_1' class='gform-field-label gform-field-label--type-inline'>Meat<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_35_18_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_18.2' type='checkbox'  value='chicken'  id='choice_35_18_2' tabindex='33'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_35_18_2' id='label_35_18_2' class='gform-field-label gform-field-label--type-inline'>Chicken<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_35_18_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_18.3' type='checkbox'  value='fish'  id='choice_35_18_3' tabindex='34'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_35_18_3' id='label_35_18_3' class='gform-field-label gform-field-label--type-inline'>Fish<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_35_18_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_18.4' type='checkbox'  value='vegetarian'  id='choice_35_18_4' tabindex='35'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_35_18_4' id='label_35_18_4' class='gform-field-label gform-field-label--type-inline'>Vegetarian<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_35_20\" class=\"gfield gfield--type-radio gfield--type-choice gf_list_inline field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>How many grams of (raw) vegetables do you usually eat?<\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_35_20'>\n\t\t\t<li class='gchoice gchoice_35_20_0'>\n\t\t\t\t<input name='input_20' type='radio' value='0'  id='choice_35_20_0' tabindex='36'   \/>\n\t\t\t\t<label for='choice_35_20_0' id='label_35_20_0' class='gform-field-label gform-field-label--type-inline'>0<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_35_20_1'>\n\t\t\t\t<input name='input_20' type='radio' value='&lt;50'  id='choice_35_20_1' tabindex='37'   \/>\n\t\t\t\t<label for='choice_35_20_1' id='label_35_20_1' class='gform-field-label gform-field-label--type-inline'>&lt;50<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_35_20_2'>\n\t\t\t\t<input name='input_20' type='radio' value='50-100'  id='choice_35_20_2' tabindex='38'   \/>\n\t\t\t\t<label for='choice_35_20_2' id='label_35_20_2' class='gform-field-label gform-field-label--type-inline'>50-100<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_35_20_3'>\n\t\t\t\t<input name='input_20' type='radio' value='100-200'  id='choice_35_20_3' tabindex='39'   \/>\n\t\t\t\t<label for='choice_35_20_3' id='label_35_20_3' class='gform-field-label gform-field-label--type-inline'>100-200<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_35_20_4'>\n\t\t\t\t<input name='input_20' type='radio' value='&gt;200'  id='choice_35_20_4' tabindex='40'   \/>\n\t\t\t\t<label for='choice_35_20_4' id='label_35_20_4' class='gform-field-label gform-field-label--type-inline'>&gt;200<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_35_21\" class=\"gfield gfield--type-radio gfield--type-choice gf_list_inline field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Do you regularly eat (unroasted) nuts and seeds?<\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_35_21'>\n\t\t\t<li class='gchoice gchoice_35_21_0'>\n\t\t\t\t<input name='input_21' type='radio' value='yes'  id='choice_35_21_0' tabindex='41'   \/>\n\t\t\t\t<label for='choice_35_21_0' id='label_35_21_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_35_21_1'>\n\t\t\t\t<input name='input_21' type='radio' value='no'  id='choice_35_21_1' tabindex='42'   \/>\n\t\t\t\t<label for='choice_35_21_1' id='label_35_21_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_35_22\" class=\"gfield gfield--type-checkbox gfield--type-choice gf_list_inline field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Which fats do you use for cooking and frying?<\/span><\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_35_22'><li class='gchoice gchoice_35_22_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_22.1' type='checkbox'  value='no'  id='choice_35_22_1' tabindex='43'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_35_22_1' id='label_35_22_1' class='gform-field-label gform-field-label--type-inline'>None<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_35_22_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_22.2' type='checkbox'  value='margarine'  id='choice_35_22_2' tabindex='44'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_35_22_2' id='label_35_22_2' class='gform-field-label gform-field-label--type-inline'>Margarine<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_35_22_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_22.3' type='checkbox'  value='halvarine'  id='choice_35_22_3' tabindex='45'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_35_22_3' id='label_35_22_3' class='gform-field-label gform-field-label--type-inline'>Halvarine<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_35_22_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_22.4' type='checkbox'  value='buttercream'  id='choice_35_22_4' tabindex='46'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_35_22_4' id='label_35_22_4' class='gform-field-label gform-field-label--type-inline'>Butter<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_35_22_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_22.5' type='checkbox'  value='vegetable oil'  id='choice_35_22_5' tabindex='47'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_35_22_5' id='label_35_22_5' class='gform-field-label gform-field-label--type-inline'>Vegetable oil<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_35_22_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_22.6' type='checkbox'  value='coconut oil'  id='choice_35_22_6' tabindex='48'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_35_22_6' id='label_35_22_6' class='gform-field-label gform-field-label--type-inline'>Coconut oil<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_35_22_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_22.7' type='checkbox'  value='olive oil'  id='choice_35_22_7' tabindex='49'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_35_22_7' id='label_35_22_7' class='gform-field-label gform-field-label--type-inline'>Olive oil<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_35_22_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_22.8' type='checkbox'  value='frying fat'  id='choice_35_22_8' tabindex='50'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_35_22_8' id='label_35_22_8' class='gform-field-label gform-field-label--type-inline'>Cooking oil<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_35_23\" class=\"gfield gfield--type-text field_sublabel_below gfield--has-description field_description_above hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label screen-reader-text' for='input_35_23'><span class='gform-field-label__text'>Other:<\/span><\/label><div class='gfield_description' id='gfield_description_35_23'>Other:<\/div><div class='ginput_container ginput_container_text'><input name='input_23' id='input_35_23' type='text' value='' class='large'  aria-describedby=\"gfield_description_35_23\" tabindex='51'   aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_35_115\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><\/br><\/li><li id=\"field_35_24\" class=\"gfield gfield--type-radio gfield--type-choice gf_list_inline field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Do you often have extreme cravings for sweets?<\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_35_24'>\n\t\t\t<li class='gchoice gchoice_35_24_0'>\n\t\t\t\t<input name='input_24' type='radio' value='yes'  id='choice_35_24_0' tabindex='52'   \/>\n\t\t\t\t<label for='choice_35_24_0' id='label_35_24_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_35_24_1'>\n\t\t\t\t<input name='input_24' type='radio' value='no'  id='choice_35_24_1' tabindex='53'   \/>\n\t\t\t\t<label for='choice_35_24_1' id='label_35_24_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_35_25\" class=\"gfield gfield--type-radio gfield--type-choice gf_list_inline field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Do you add sugar?<\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_35_25'>\n\t\t\t<li class='gchoice gchoice_35_25_0'>\n\t\t\t\t<input name='input_25' type='radio' value='yes'  id='choice_35_25_0' tabindex='54'   \/>\n\t\t\t\t<label for='choice_35_25_0' id='label_35_25_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_35_25_1'>\n\t\t\t\t<input name='input_25' type='radio' value='no'  id='choice_35_25_1' tabindex='55'   \/>\n\t\t\t\t<label for='choice_35_25_1' id='label_35_25_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_35_26\" class=\"gfield gfield--type-radio gfield--type-choice gf_list_inline field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Do you add salt?<\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_35_26'>\n\t\t\t<li class='gchoice gchoice_35_26_0'>\n\t\t\t\t<input name='input_26' type='radio' value='yes'  id='choice_35_26_0' tabindex='56'   \/>\n\t\t\t\t<label for='choice_35_26_0' id='label_35_26_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_35_26_1'>\n\t\t\t\t<input name='input_26' type='radio' value='no'  id='choice_35_26_1' tabindex='57'   \/>\n\t\t\t\t<label for='choice_35_26_1' id='label_35_26_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_35_27\" class=\"gfield gfield--type-radio gfield--type-choice gf_list_inline field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Can you easily skip meals?<\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_35_27'>\n\t\t\t<li class='gchoice gchoice_35_27_0'>\n\t\t\t\t<input name='input_27' type='radio' value='yes'  id='choice_35_27_0' tabindex='58'   \/>\n\t\t\t\t<label for='choice_35_27_0' id='label_35_27_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_35_27_1'>\n\t\t\t\t<input name='input_27' type='radio' value='no'  id='choice_35_27_1' tabindex='59'   \/>\n\t\t\t\t<label for='choice_35_27_1' id='label_35_27_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_35_28\" class=\"gfield gfield--type-checkbox gfield--type-choice gf_list_inline field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>If so, which meals do you skip?<\/span><\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_35_28'><li class='gchoice gchoice_35_28_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_28.1' type='checkbox'  value='breakfast'  id='choice_35_28_1' tabindex='60'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_35_28_1' id='label_35_28_1' class='gform-field-label gform-field-label--type-inline'>Breakfast<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_35_28_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_28.2' type='checkbox'  value='lunch'  id='choice_35_28_2' tabindex='61'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_35_28_2' id='label_35_28_2' class='gform-field-label gform-field-label--type-inline'>Lunch<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_35_28_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_28.3' type='checkbox'  value='dinner'  id='choice_35_28_3' tabindex='62'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_35_28_3' id='label_35_28_3' class='gform-field-label gform-field-label--type-inline'>Dinner<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_35_29\" class=\"gfield gfield--type-radio gfield--type-choice gf_list_inline field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Do you often binge-eat?<\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_35_29'>\n\t\t\t<li class='gchoice gchoice_35_29_0'>\n\t\t\t\t<input name='input_29' type='radio' value='yes'  id='choice_35_29_0' tabindex='63'   \/>\n\t\t\t\t<label for='choice_35_29_0' id='label_35_29_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_35_29_1'>\n\t\t\t\t<input name='input_29' type='radio' value='no'  id='choice_35_29_1' tabindex='64'   \/>\n\t\t\t\t<label for='choice_35_29_1' id='label_35_29_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_35_30\" class=\"gfield gfield--type-radio gfield--type-choice gf_list_inline field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Do you often feel bloated after a meal?<\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_35_30'>\n\t\t\t<li class='gchoice gchoice_35_30_0'>\n\t\t\t\t<input name='input_30' type='radio' value='yes'  id='choice_35_30_0' tabindex='65'   \/>\n\t\t\t\t<label for='choice_35_30_0' id='label_35_30_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_35_30_1'>\n\t\t\t\t<input name='input_30' type='radio' value='no'  id='choice_35_30_1' tabindex='66'   \/>\n\t\t\t\t<label for='choice_35_30_1' id='label_35_30_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_35_111\" class=\"gfield gfield--type-radio gfield--type-choice gf_list_inline field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Are you allergic to any foods?<\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_35_111'>\n\t\t\t<li class='gchoice gchoice_35_111_0'>\n\t\t\t\t<input name='input_111' type='radio' value='yes'  id='choice_35_111_0' tabindex='67'   \/>\n\t\t\t\t<label for='choice_35_111_0' id='label_35_111_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_35_111_1'>\n\t\t\t\t<input name='input_111' type='radio' value='no'  id='choice_35_111_1' tabindex='68'   \/>\n\t\t\t\t<label for='choice_35_111_1' id='label_35_111_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_35_111_2'>\n\t\t\t\t<input name='input_111' type='radio' value='maybe'  id='choice_35_111_2' tabindex='69'   \/>\n\t\t\t\t<label for='choice_35_111_2' id='label_35_111_2' class='gform-field-label gform-field-label--type-inline'>Maybe<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_35_32\" class=\"gfield gfield--type-text field_sublabel_below gfield--has-description field_description_above hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label screen-reader-text' for='input_35_32'><span class='gform-field-label__text'>If yes or maybe, which:<\/span><\/label><div class='gfield_description' id='gfield_description_35_32'>If yes or maybe, which:  <\/div><div class='ginput_container ginput_container_text'><input name='input_32' id='input_35_32' type='text' value='' class='large'  aria-describedby=\"gfield_description_35_32\" tabindex='70'   aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_35_116\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><\/br><\/li><li id=\"field_35_33\" class=\"gfield gfield--type-radio gfield--type-choice gf_list_inline field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Have you ever been on a diet?<\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_35_33'>\n\t\t\t<li class='gchoice gchoice_35_33_0'>\n\t\t\t\t<input name='input_33' type='radio' value='yes'  id='choice_35_33_0' tabindex='71'   \/>\n\t\t\t\t<label for='choice_35_33_0' id='label_35_33_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_35_33_1'>\n\t\t\t\t<input name='input_33' type='radio' value='no'  id='choice_35_33_1' tabindex='72'   \/>\n\t\t\t\t<label for='choice_35_33_1' id='label_35_33_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_35_34\" class=\"gfield gfield--type-text field_sublabel_below gfield--has-description field_description_above hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label screen-reader-text' for='input_35_34'><span class='gform-field-label__text'>If yes, which diet(s):<\/span><\/label><div class='gfield_description' id='gfield_description_35_34'>If yes, which diet(s):  <\/div><div class='ginput_container ginput_container_text'><input name='input_34' id='input_35_34' type='text' value='' class='large'  aria-describedby=\"gfield_description_35_34\" tabindex='73'   aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_35_117\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><\/br><\/li><li id=\"field_35_35\" class=\"gfield gfield--type-radio gfield--type-choice gf_list_inline field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>What kind of short-term results did this deliver?<\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_35_35'>\n\t\t\t<li class='gchoice gchoice_35_35_0'>\n\t\t\t\t<input name='input_35' type='radio' value='no'  id='choice_35_35_0' tabindex='74'   \/>\n\t\t\t\t<label for='choice_35_35_0' id='label_35_35_0' class='gform-field-label gform-field-label--type-inline'>None<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_35_35_1'>\n\t\t\t\t<input name='input_35' type='radio' value='insufficient'  id='choice_35_35_1' tabindex='75'   \/>\n\t\t\t\t<label for='choice_35_35_1' id='label_35_35_1' class='gform-field-label gform-field-label--type-inline'>Insufficient<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_35_35_2'>\n\t\t\t\t<input name='input_35' type='radio' value='sufficient'  id='choice_35_35_2' tabindex='76'   \/>\n\t\t\t\t<label for='choice_35_35_2' id='label_35_35_2' class='gform-field-label gform-field-label--type-inline'>Sufficient<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_35_35_3'>\n\t\t\t\t<input name='input_35' type='radio' value='good'  id='choice_35_35_3' tabindex='77'   \/>\n\t\t\t\t<label for='choice_35_35_3' id='label_35_35_3' class='gform-field-label gform-field-label--type-inline'>Great<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_35_36\" class=\"gfield gfield--type-text field_sublabel_below gfield--has-description field_description_above hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label screen-reader-text' for='input_35_36'><span class='gform-field-label__text'>How many maximum kg lost?<\/span><\/label><div class='gfield_description' id='gfield_description_35_36'>How many maximum kg lost?  <\/div><div class='ginput_container ginput_container_text'><input name='input_36' id='input_35_36' type='text' value='' class='large'  aria-describedby=\"gfield_description_35_36\" tabindex='78'   aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_35_118\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><\/br><\/li><li id=\"field_35_37\" class=\"gfield gfield--type-radio gfield--type-choice gf_list_inline field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>What kind of long-term results did this deliver?<\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_35_37'>\n\t\t\t<li class='gchoice gchoice_35_37_0'>\n\t\t\t\t<input name='input_37' type='radio' value='no'  id='choice_35_37_0' tabindex='79'   \/>\n\t\t\t\t<label for='choice_35_37_0' id='label_35_37_0' class='gform-field-label gform-field-label--type-inline'>None<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_35_37_1'>\n\t\t\t\t<input name='input_37' type='radio' value='insufficient'  id='choice_35_37_1' tabindex='80'   \/>\n\t\t\t\t<label for='choice_35_37_1' id='label_35_37_1' class='gform-field-label gform-field-label--type-inline'>Insufficient<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_35_37_2'>\n\t\t\t\t<input name='input_37' type='radio' value='sufficient'  id='choice_35_37_2' tabindex='81'   \/>\n\t\t\t\t<label for='choice_35_37_2' id='label_35_37_2' class='gform-field-label gform-field-label--type-inline'>Sufficient<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_35_37_3'>\n\t\t\t\t<input name='input_37' type='radio' value='good'  id='choice_35_37_3' tabindex='82'   \/>\n\t\t\t\t<label for='choice_35_37_3' id='label_35_37_3' class='gform-field-label gform-field-label--type-inline'>Great<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_35_38\" class=\"gfield gfield--type-text field_sublabel_below gfield--has-description field_description_above hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label screen-reader-text' for='input_35_38'><span class='gform-field-label__text'>How many kg lost or gained?<\/span><\/label><div class='gfield_description' id='gfield_description_35_38'>How many kg lost or gained?  <\/div><div class='ginput_container ginput_container_text'><input name='input_38' id='input_35_38' type='text' value='' class='large'  aria-describedby=\"gfield_description_35_38\" tabindex='83'   aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_35_119\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><\/br><\/li><li id=\"field_35_39\" class=\"gfield gfield--type-radio gfield--type-choice gf_list_inline field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Do you have dietary restrictions?<\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_35_39'>\n\t\t\t<li class='gchoice gchoice_35_39_0'>\n\t\t\t\t<input name='input_39' type='radio' value='yes'  id='choice_35_39_0' tabindex='84'   \/>\n\t\t\t\t<label for='choice_35_39_0' id='label_35_39_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_35_39_1'>\n\t\t\t\t<input name='input_39' type='radio' value='no'  id='choice_35_39_1' tabindex='85'   \/>\n\t\t\t\t<label for='choice_35_39_1' id='label_35_39_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_35_40\" class=\"gfield gfield--type-text field_sublabel_below gfield--has-description field_description_above hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_35_40'><span class='gform-field-label__text'>dietary restrictions_yes<\/span><\/label><div class='gfield_description' id='gfield_description_35_40'>If yes, which<\/div><div class='ginput_container ginput_container_text'><input name='input_40' id='input_35_40' type='text' value='' class='large'  aria-describedby=\"gfield_description_35_40\" tabindex='86'   aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_35_120\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><\/br><\/li><li id=\"field_35_41\" class=\"gfield gfield--type-radio gfield--type-choice gf_list_inline field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Do you use vitamin\/mineral supplements?<\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_35_41'>\n\t\t\t<li class='gchoice gchoice_35_41_0'>\n\t\t\t\t<input name='input_41' type='radio' value='yes'  id='choice_35_41_0' tabindex='87'   \/>\n\t\t\t\t<label for='choice_35_41_0' id='label_35_41_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_35_41_1'>\n\t\t\t\t<input name='input_41' type='radio' value='no'  id='choice_35_41_1' tabindex='88'   \/>\n\t\t\t\t<label for='choice_35_41_1' id='label_35_41_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_35_42\" class=\"gfield gfield--type-text field_sublabel_below gfield--has-description field_description_above hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_35_42'><span class='gform-field-label__text'>supplements_yes<\/span><\/label><div class='gfield_description' id='gfield_description_35_42'>If yes, which and how many?<\/div><div class='ginput_container ginput_container_text'><input name='input_42' id='input_35_42' type='text' value='' class='large'  aria-describedby=\"gfield_description_35_42\" tabindex='89'   aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_35_121\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><\/br><\/li><li id=\"field_35_44\" class=\"gfield gfield--type-radio gfield--type-choice gf_list_inline field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Do you cook for others?<\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_35_44'>\n\t\t\t<li class='gchoice gchoice_35_44_0'>\n\t\t\t\t<input name='input_44' type='radio' value='yes'  id='choice_35_44_0' tabindex='90'   \/>\n\t\t\t\t<label for='choice_35_44_0' id='label_35_44_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_35_44_1'>\n\t\t\t\t<input name='input_44' type='radio' value='no'  id='choice_35_44_1' tabindex='91'   \/>\n\t\t\t\t<label for='choice_35_44_1' id='label_35_44_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_35_43\" class=\"gfield gfield--type-text field_sublabel_below gfield--has-description field_description_above hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_35_43'><span class='gform-field-label__text'>cooking for othershow often<\/span><\/label><div class='gfield_description' id='gfield_description_35_43'>If yes how many times per week?  <\/div><div class='ginput_container ginput_container_text'><input name='input_43' id='input_35_43' type='text' value='' class='large'  aria-describedby=\"gfield_description_35_43\" tabindex='92'   aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_35_122\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><\/br><\/li><li id=\"field_35_45\" class=\"gfield gfield--type-checkbox gfield--type-choice gf_list_inline field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>What do you drink regularly?<\/span><\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_35_45'><li class='gchoice gchoice_35_45_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_45.1' type='checkbox'  value='coffee'  id='choice_35_45_1' tabindex='93'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_35_45_1' id='label_35_45_1' class='gform-field-label gform-field-label--type-inline'>Coffee<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_35_45_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_45.2' type='checkbox'  value='tea'  id='choice_35_45_2' tabindex='94'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_35_45_2' id='label_35_45_2' class='gform-field-label gform-field-label--type-inline'>Tea<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_35_45_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_45.3' type='checkbox'  value='water'  id='choice_35_45_3' tabindex='95'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_35_45_3' id='label_35_45_3' class='gform-field-label gform-field-label--type-inline'>Water<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_35_45_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_45.4' type='checkbox'  value='milk'  id='choice_35_45_4' tabindex='96'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_35_45_4' id='label_35_45_4' class='gform-field-label gform-field-label--type-inline'>Milk<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_35_45_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_45.5' type='checkbox'  value='soda'  id='choice_35_45_5' tabindex='97'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_35_45_5' id='label_35_45_5' class='gform-field-label gform-field-label--type-inline'>Soft drinks<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_35_45_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_45.6' type='checkbox'  value='fruit juice'  id='choice_35_45_6' tabindex='98'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_35_45_6' id='label_35_45_6' class='gform-field-label gform-field-label--type-inline'>Fruit juices<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_35_45_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_45.7' type='checkbox'  value='alcohol'  id='choice_35_45_7' tabindex='99'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_35_45_7' id='label_35_45_7' class='gform-field-label gform-field-label--type-inline'>Alcohol<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_35_45_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_45.8' type='checkbox'  value='none of them'  id='choice_35_45_8' tabindex='100'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_35_45_8' id='label_35_45_8' class='gform-field-label gform-field-label--type-inline'>None of the above<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_35_46\" class=\"gfield gfield--type-radio gfield--type-choice gf_list_inline field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Do you drink coffee?<\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_35_46'>\n\t\t\t<li class='gchoice gchoice_35_46_0'>\n\t\t\t\t<input name='input_46' type='radio' value='yes'  id='choice_35_46_0' tabindex='101'   \/>\n\t\t\t\t<label for='choice_35_46_0' id='label_35_46_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_35_46_1'>\n\t\t\t\t<input name='input_46' type='radio' value='no'  id='choice_35_46_1' tabindex='102'   \/>\n\t\t\t\t<label for='choice_35_46_1' id='label_35_46_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_35_47\" class=\"gfield gfield--type-radio gfield--type-choice gf_list_inline field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>If yes, how many cups per day?<\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_35_47'>\n\t\t\t<li class='gchoice gchoice_35_47_0'>\n\t\t\t\t<input name='input_47' type='radio' value='1-3'  id='choice_35_47_0' tabindex='103'   \/>\n\t\t\t\t<label for='choice_35_47_0' id='label_35_47_0' class='gform-field-label gform-field-label--type-inline'>1-3<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_35_47_1'>\n\t\t\t\t<input name='input_47' type='radio' value='3-5'  id='choice_35_47_1' tabindex='104'   \/>\n\t\t\t\t<label for='choice_35_47_1' id='label_35_47_1' class='gform-field-label gform-field-label--type-inline'>3-5<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_35_47_2'>\n\t\t\t\t<input name='input_47' type='radio' value='5&gt;'  id='choice_35_47_2' tabindex='105'   \/>\n\t\t\t\t<label for='choice_35_47_2' id='label_35_47_2' class='gform-field-label gform-field-label--type-inline'>5&gt;<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_35_48\" class=\"gfield gfield--type-radio gfield--type-choice gf_list_inline field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Do you drink alcoholic beverages?<\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_35_48'>\n\t\t\t<li class='gchoice gchoice_35_48_0'>\n\t\t\t\t<input name='input_48' type='radio' value='yes'  id='choice_35_48_0' tabindex='106'   \/>\n\t\t\t\t<label for='choice_35_48_0' id='label_35_48_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_35_48_1'>\n\t\t\t\t<input name='input_48' type='radio' value='no'  id='choice_35_48_1' tabindex='107'   \/>\n\t\t\t\t<label for='choice_35_48_1' id='label_35_48_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_35_49\" class=\"gfield gfield--type-text field_sublabel_below gfield--has-description field_description_above hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_35_49'><span class='gform-field-label__text'>drinks_yes<\/span><\/label><div class='gfield_description' id='gfield_description_35_49'>If yes, which:<\/div><div class='ginput_container ginput_container_text'><input name='input_49' id='input_35_49' type='text' value='' class='large'  aria-describedby=\"gfield_description_35_49\" tabindex='108'   aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_35_123\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><\/br><\/li><li id=\"field_35_50\" class=\"gfield gfield--type-text field_sublabel_below gfield--has-description field_description_above hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_35_50'><span class='gform-field-label__text'>drinks_ja2<\/span><\/label><div class='gfield_description' id='gfield_description_35_50'>If yes, how many glasses per week?  <\/div><div class='ginput_container ginput_container_text'><input name='input_50' id='input_35_50' type='text' value='' class='large'  aria-describedby=\"gfield_description_35_50\" tabindex='109'   aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_35_124\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><\/br><\/li><li id=\"field_35_106\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><\/br><hr><strong>Questions regarding health (-past):<\/strong><\/br><\/br><\/li><li id=\"field_35_53\" class=\"gfield gfield--type-radio gfield--type-choice gf_list_inline field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Do you have any major concerns about your health?<\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_35_53'>\n\t\t\t<li class='gchoice gchoice_35_53_0'>\n\t\t\t\t<input name='input_53' type='radio' value='yes'  id='choice_35_53_0' tabindex='110'   \/>\n\t\t\t\t<label for='choice_35_53_0' id='label_35_53_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_35_53_1'>\n\t\t\t\t<input name='input_53' type='radio' value='no'  id='choice_35_53_1' tabindex='111'   \/>\n\t\t\t\t<label for='choice_35_53_1' id='label_35_53_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_35_54\" class=\"gfield gfield--type-text field_sublabel_below gfield--has-description field_description_above hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_35_54'><span class='gform-field-label__text'>worry_yes<\/span><\/label><div class='gfield_description' id='gfield_description_35_54'>If yes, about what?  <\/div><div class='ginput_container ginput_container_text'><input name='input_54' id='input_35_54' type='text' value='' class='large'  aria-describedby=\"gfield_description_35_54\" tabindex='112'   aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_35_125\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><\/br><\/li><li id=\"field_35_55\" class=\"gfield gfield--type-radio gfield--type-choice gf_list_inline field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Do you have health complaints?<\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_35_55'>\n\t\t\t<li class='gchoice gchoice_35_55_0'>\n\t\t\t\t<input name='input_55' type='radio' value='yes'  id='choice_35_55_0' tabindex='113'   \/>\n\t\t\t\t<label for='choice_35_55_0' id='label_35_55_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_35_55_1'>\n\t\t\t\t<input name='input_55' type='radio' value='no'  id='choice_35_55_1' tabindex='114'   \/>\n\t\t\t\t<label for='choice_35_55_1' id='label_35_55_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_35_56\" class=\"gfield gfield--type-text field_sublabel_below gfield--has-description field_description_above hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_35_56'><span class='gform-field-label__text'>health complaints_yes<\/span><\/label><div class='gfield_description' id='gfield_description_35_56'>If yes, which one?  <\/div><div class='ginput_container ginput_container_text'><input name='input_56' id='input_35_56' type='text' value='' class='large'  aria-describedby=\"gfield_description_35_56\" tabindex='115'   aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_35_126\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><\/br><\/li><li id=\"field_35_57\" class=\"gfield gfield--type-radio gfield--type-choice gf_list_inline field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Do you smoke?<\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_35_57'>\n\t\t\t<li class='gchoice gchoice_35_57_0'>\n\t\t\t\t<input name='input_57' type='radio' value='yes'  id='choice_35_57_0' tabindex='116'   \/>\n\t\t\t\t<label for='choice_35_57_0' id='label_35_57_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_35_57_1'>\n\t\t\t\t<input name='input_57' type='radio' value='no'  id='choice_35_57_1' tabindex='117'   \/>\n\t\t\t\t<label for='choice_35_57_1' id='label_35_57_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_35_58\" class=\"gfield gfield--type-text field_sublabel_below gfield--has-description field_description_above hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_35_58'><span class='gform-field-label__text'>smoking_yes<\/span><\/label><div class='gfield_description' id='gfield_description_35_58'>If yes, how much?<\/div><div class='ginput_container ginput_container_text'><input name='input_58' id='input_35_58' type='text' value='' class='large'  aria-describedby=\"gfield_description_35_58\" tabindex='118'   aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_35_127\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><\/br><\/li><li id=\"field_35_61\" class=\"gfield gfield--type-radio gfield--type-choice gf_list_inline field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Do you use medication or painkillers?<\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_35_61'>\n\t\t\t<li class='gchoice gchoice_35_61_0'>\n\t\t\t\t<input name='input_61' type='radio' value='yes'  id='choice_35_61_0' tabindex='119'   \/>\n\t\t\t\t<label for='choice_35_61_0' id='label_35_61_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_35_61_1'>\n\t\t\t\t<input name='input_61' type='radio' value='no'  id='choice_35_61_1' tabindex='120'   \/>\n\t\t\t\t<label for='choice_35_61_1' id='label_35_61_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_35_60\" class=\"gfield gfield--type-text field_sublabel_below gfield--has-description field_description_above hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_35_60'><span class='gform-field-label__text'>medicine_yes<\/span><\/label><div class='gfield_description' id='gfield_description_35_60'>If yes, which one?  <\/div><div class='ginput_container ginput_container_text'><input name='input_60' id='input_35_60' type='text' value='' class='large'  aria-describedby=\"gfield_description_35_60\" tabindex='121'   aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_35_128\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><\/br><\/li><li id=\"field_35_59\" class=\"gfield gfield--type-radio gfield--type-choice gf_list_inline field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Do you take soft\/hard drugs?<\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_35_59'>\n\t\t\t<li class='gchoice gchoice_35_59_0'>\n\t\t\t\t<input name='input_59' type='radio' value='yes'  id='choice_35_59_0' tabindex='122'   \/>\n\t\t\t\t<label for='choice_35_59_0' id='label_35_59_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_35_59_1'>\n\t\t\t\t<input name='input_59' type='radio' value='no'  id='choice_35_59_1' tabindex='123'   \/>\n\t\t\t\t<label for='choice_35_59_1' id='label_35_59_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_35_62\" class=\"gfield gfield--type-text field_sublabel_below gfield--has-description field_description_above hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_35_62'><span class='gform-field-label__text'>drug_yes<\/span><\/label><div class='gfield_description' id='gfield_description_35_62'>If yes, which and how much?  <\/div><div class='ginput_container ginput_container_text'><input name='input_62' id='input_35_62' type='text' value='' class='large'  aria-describedby=\"gfield_description_35_62\" tabindex='124'   aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_35_129\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><\/br><\/li><li id=\"field_35_63\" class=\"gfield gfield--type-radio gfield--type-choice gf_list_inline field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Have you ever been prescribed an antibiotics course?<\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_35_63'>\n\t\t\t<li class='gchoice gchoice_35_63_0'>\n\t\t\t\t<input name='input_63' type='radio' value='yes'  id='choice_35_63_0' tabindex='125'   \/>\n\t\t\t\t<label for='choice_35_63_0' id='label_35_63_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_35_63_1'>\n\t\t\t\t<input name='input_63' type='radio' value='no'  id='choice_35_63_1' tabindex='126'   \/>\n\t\t\t\t<label for='choice_35_63_1' id='label_35_63_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_35_64\" class=\"gfield gfield--type-text field_sublabel_below gfield--has-description field_description_above hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_35_64'><span class='gform-field-label__text'>antibiotics_yes<\/span><\/label><div class='gfield_description' id='gfield_description_35_64'>If yes, for which condition?  <\/div><div class='ginput_container ginput_container_text'><input name='input_64' id='input_35_64' type='text' value='' class='large'  aria-describedby=\"gfield_description_35_64\" tabindex='127'   aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_35_130\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><\/br><\/li><li id=\"field_35_65\" class=\"gfield gfield--type-radio gfield--type-choice gf_list_inline field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>If yes, did you take a course of probiotics?<\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_35_65'>\n\t\t\t<li class='gchoice gchoice_35_65_0'>\n\t\t\t\t<input name='input_65' type='radio' value='yes'  id='choice_35_65_0' tabindex='128'   \/>\n\t\t\t\t<label for='choice_35_65_0' id='label_35_65_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_35_65_1'>\n\t\t\t\t<input name='input_65' type='radio' value='no'  id='choice_35_65_1' tabindex='129'   \/>\n\t\t\t\t<label for='choice_35_65_1' id='label_35_65_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_35_66\" class=\"gfield gfield--type-text field_sublabel_below gfield--has-description field_description_above hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_35_66'><span class='gform-field-label__text'>mancos<\/span><\/label><div class='gfield_description' id='gfield_description_35_66'>What health deficiencies have manifested themselves over the years?<\/div><div class='ginput_container ginput_container_text'><input name='input_66' id='input_35_66' type='text' value='' class='large'  aria-describedby=\"gfield_description_35_66\" tabindex='130'   aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_35_132\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><\/br><\/li><li id=\"field_35_67\" class=\"gfield gfield--type-radio gfield--type-choice gf_list_inline field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Have you undergone any operations?<\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_35_67'>\n\t\t\t<li class='gchoice gchoice_35_67_0'>\n\t\t\t\t<input name='input_67' type='radio' value='yes'  id='choice_35_67_0' tabindex='131'   \/>\n\t\t\t\t<label for='choice_35_67_0' id='label_35_67_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_35_67_1'>\n\t\t\t\t<input name='input_67' type='radio' value='no'  id='choice_35_67_1' tabindex='132'   \/>\n\t\t\t\t<label for='choice_35_67_1' id='label_35_67_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_35_68\" class=\"gfield gfield--type-text field_sublabel_below gfield--has-description field_description_above hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_35_68'><span class='gform-field-label__text'>operations_yes<\/span><\/label><div class='gfield_description' id='gfield_description_35_68'>If yes, which one?  <\/div><div class='ginput_container ginput_container_text'><input name='input_68' id='input_35_68' type='text' value='' class='large'  aria-describedby=\"gfield_description_35_68\" tabindex='133'   aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_35_133\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><\/br><\/li><li id=\"field_35_69\" class=\"gfield gfield--type-radio gfield--type-choice gf_list_inline field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Have you ever been diagnosed with hypoglycaemia (low blood glucose)?<\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_35_69'>\n\t\t\t<li class='gchoice gchoice_35_69_0'>\n\t\t\t\t<input name='input_69' type='radio' value='yes'  id='choice_35_69_0' tabindex='134'   \/>\n\t\t\t\t<label for='choice_35_69_0' id='label_35_69_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_35_69_1'>\n\t\t\t\t<input name='input_69' type='radio' value='no'  id='choice_35_69_1' tabindex='135'   \/>\n\t\t\t\t<label for='choice_35_69_1' id='label_35_69_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_35_69_2'>\n\t\t\t\t<input name='input_69' type='radio' value='never measured'  id='choice_35_69_2' tabindex='136'   \/>\n\t\t\t\t<label for='choice_35_69_2' id='label_35_69_2' class='gform-field-label gform-field-label--type-inline'>Never measured<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_35_70\" class=\"gfield gfield--type-radio gfield--type-choice gf_list_inline field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Do you sweat a lot?<\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_35_70'>\n\t\t\t<li class='gchoice gchoice_35_70_0'>\n\t\t\t\t<input name='input_70' type='radio' value='yes'  id='choice_35_70_0' tabindex='137'   \/>\n\t\t\t\t<label for='choice_35_70_0' id='label_35_70_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_35_70_1'>\n\t\t\t\t<input name='input_70' type='radio' value='no'  id='choice_35_70_1' tabindex='138'   \/>\n\t\t\t\t<label for='choice_35_70_1' id='label_35_70_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_35_72\" class=\"gfield gfield--type-radio gfield--type-choice gf_list_inline field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Do you have skin concerns?<\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_35_72'>\n\t\t\t<li class='gchoice gchoice_35_72_0'>\n\t\t\t\t<input name='input_72' type='radio' value='yes'  id='choice_35_72_0' tabindex='139'   \/>\n\t\t\t\t<label for='choice_35_72_0' id='label_35_72_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_35_72_1'>\n\t\t\t\t<input name='input_72' type='radio' value='no'  id='choice_35_72_1' tabindex='140'   \/>\n\t\t\t\t<label for='choice_35_72_1' id='label_35_72_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_35_73\" class=\"gfield gfield--type-radio gfield--type-choice gf_list_inline field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Do you have any joint concerns or complaints?<\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_35_73'>\n\t\t\t<li class='gchoice gchoice_35_73_0'>\n\t\t\t\t<input name='input_73' type='radio' value='yes'  id='choice_35_73_0' tabindex='141'   \/>\n\t\t\t\t<label for='choice_35_73_0' id='label_35_73_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_35_73_1'>\n\t\t\t\t<input name='input_73' type='radio' value='no'  id='choice_35_73_1' tabindex='142'   \/>\n\t\t\t\t<label for='choice_35_73_1' id='label_35_73_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_35_73_2'>\n\t\t\t\t<input name='input_73' type='radio' value='sometimes'  id='choice_35_73_2' tabindex='143'   \/>\n\t\t\t\t<label for='choice_35_73_2' id='label_35_73_2' class='gform-field-label gform-field-label--type-inline'>Sometimes<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_35_74\" class=\"gfield gfield--type-radio gfield--type-choice gf_list_inline field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Do you have digestive issues?<\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_35_74'>\n\t\t\t<li class='gchoice gchoice_35_74_0'>\n\t\t\t\t<input name='input_74' type='radio' value='yes'  id='choice_35_74_0' tabindex='144'   \/>\n\t\t\t\t<label for='choice_35_74_0' id='label_35_74_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_35_74_1'>\n\t\t\t\t<input name='input_74' type='radio' value='no'  id='choice_35_74_1' tabindex='145'   \/>\n\t\t\t\t<label for='choice_35_74_1' id='label_35_74_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_35_74_2'>\n\t\t\t\t<input name='input_74' type='radio' value='sometimes'  id='choice_35_74_2' tabindex='146'   \/>\n\t\t\t\t<label for='choice_35_74_2' id='label_35_74_2' class='gform-field-label gform-field-label--type-inline'>Sometimes<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_35_75\" class=\"gfield gfield--type-radio gfield--type-choice gf_list_inline field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Do you have regular bowel movements?<\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_35_75'>\n\t\t\t<li class='gchoice gchoice_35_75_0'>\n\t\t\t\t<input name='input_75' type='radio' value='yes'  id='choice_35_75_0' tabindex='147'   \/>\n\t\t\t\t<label for='choice_35_75_0' id='label_35_75_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_35_75_1'>\n\t\t\t\t<input name='input_75' type='radio' value='no'  id='choice_35_75_1' tabindex='148'   \/>\n\t\t\t\t<label for='choice_35_75_1' id='label_35_75_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_35_75_2'>\n\t\t\t\t<input name='input_75' type='radio' value='sometimes'  id='choice_35_75_2' tabindex='149'   \/>\n\t\t\t\t<label for='choice_35_75_2' id='label_35_75_2' class='gform-field-label gform-field-label--type-inline'>Sometimes<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_35_76\" class=\"gfield gfield--type-radio gfield--type-choice gf_list_inline field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>If no or sometimes, in what sense is this different?<\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_35_76'>\n\t\t\t<li class='gchoice gchoice_35_76_0'>\n\t\t\t\t<input name='input_76' type='radio' value='frequency'  id='choice_35_76_0' tabindex='150'   \/>\n\t\t\t\t<label for='choice_35_76_0' id='label_35_76_0' class='gform-field-label gform-field-label--type-inline'>Frequency<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_35_76_1'>\n\t\t\t\t<input name='input_76' type='radio' value='color'  id='choice_35_76_1' tabindex='151'   \/>\n\t\t\t\t<label for='choice_35_76_1' id='label_35_76_1' class='gform-field-label gform-field-label--type-inline'>Color<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_35_76_2'>\n\t\t\t\t<input name='input_76' type='radio' value='scent'  id='choice_35_76_2' tabindex='152'   \/>\n\t\t\t\t<label for='choice_35_76_2' id='label_35_76_2' class='gform-field-label gform-field-label--type-inline'>Smell<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_35_76_3'>\n\t\t\t\t<input name='input_76' type='radio' value='composition'  id='choice_35_76_3' tabindex='153'   \/>\n\t\t\t\t<label for='choice_35_76_3' id='label_35_76_3' class='gform-field-label gform-field-label--type-inline'>Consistency<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_35_77\" class=\"gfield gfield--type-radio gfield--type-choice gf_list_inline field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Is your bodyweight stable?<\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_35_77'>\n\t\t\t<li class='gchoice gchoice_35_77_0'>\n\t\t\t\t<input name='input_77' type='radio' value='yes'  id='choice_35_77_0' tabindex='154'   \/>\n\t\t\t\t<label for='choice_35_77_0' id='label_35_77_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_35_77_1'>\n\t\t\t\t<input name='input_77' type='radio' value='no'  id='choice_35_77_1' tabindex='155'   \/>\n\t\t\t\t<label for='choice_35_77_1' id='label_35_77_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_35_78\" class=\"gfield gfield--type-radio gfield--type-choice gf_list_inline field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>How would you describe your blood pressure?<\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_35_78'>\n\t\t\t<li class='gchoice gchoice_35_78_0'>\n\t\t\t\t<input name='input_78' type='radio' value='low'  id='choice_35_78_0' tabindex='156'   \/>\n\t\t\t\t<label for='choice_35_78_0' id='label_35_78_0' class='gform-field-label gform-field-label--type-inline'>Low<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_35_78_1'>\n\t\t\t\t<input name='input_78' type='radio' value='normal'  id='choice_35_78_1' tabindex='157'   \/>\n\t\t\t\t<label for='choice_35_78_1' id='label_35_78_1' class='gform-field-label gform-field-label--type-inline'>Normal<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_35_78_2'>\n\t\t\t\t<input name='input_78' type='radio' value='high'  id='choice_35_78_2' tabindex='158'   \/>\n\t\t\t\t<label for='choice_35_78_2' id='label_35_78_2' class='gform-field-label gform-field-label--type-inline'>High<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_35_78_3'>\n\t\t\t\t<input name='input_78' type='radio' value='changing'  id='choice_35_78_3' tabindex='159'   \/>\n\t\t\t\t<label for='choice_35_78_3' id='label_35_78_3' class='gform-field-label gform-field-label--type-inline'>Varying<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_35_78_4'>\n\t\t\t\t<input name='input_78' type='radio' value='don&#039;t know'  id='choice_35_78_4' tabindex='160'   \/>\n\t\t\t\t<label for='choice_35_78_4' id='label_35_78_4' class='gform-field-label gform-field-label--type-inline'>Do not know<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_35_79\" class=\"gfield gfield--type-radio gfield--type-choice gf_list_inline field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Do you have any issues with your sleep?<\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_35_79'>\n\t\t\t<li class='gchoice gchoice_35_79_0'>\n\t\t\t\t<input name='input_79' type='radio' value='always'  id='choice_35_79_0' tabindex='161'   \/>\n\t\t\t\t<label for='choice_35_79_0' id='label_35_79_0' class='gform-field-label gform-field-label--type-inline'>Always<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_35_79_1'>\n\t\t\t\t<input name='input_79' type='radio' value='sometimes'  id='choice_35_79_1' tabindex='162'   \/>\n\t\t\t\t<label for='choice_35_79_1' id='label_35_79_1' class='gform-field-label gform-field-label--type-inline'>Sometimes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_35_79_2'>\n\t\t\t\t<input name='input_79' type='radio' value='never'  id='choice_35_79_2' tabindex='163'   \/>\n\t\t\t\t<label for='choice_35_79_2' id='label_35_79_2' class='gform-field-label gform-field-label--type-inline'>Never<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_35_80\" class=\"gfield gfield--type-radio gfield--type-choice gf_list_inline field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Do you wake up easily and feeling rested?<\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_35_80'>\n\t\t\t<li class='gchoice gchoice_35_80_0'>\n\t\t\t\t<input name='input_80' type='radio' value='always'  id='choice_35_80_0' tabindex='164'   \/>\n\t\t\t\t<label for='choice_35_80_0' id='label_35_80_0' class='gform-field-label gform-field-label--type-inline'>Always<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_35_80_1'>\n\t\t\t\t<input name='input_80' type='radio' value='sometimes'  id='choice_35_80_1' tabindex='165'   \/>\n\t\t\t\t<label for='choice_35_80_1' id='label_35_80_1' class='gform-field-label gform-field-label--type-inline'>Sometimes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_35_80_2'>\n\t\t\t\t<input name='input_80' type='radio' value='never'  id='choice_35_80_2' tabindex='166'   \/>\n\t\t\t\t<label for='choice_35_80_2' id='label_35_80_2' class='gform-field-label gform-field-label--type-inline'>Never<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_35_81\" class=\"gfield gfield--type-text field_sublabel_below gfield--has-description field_description_above hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_35_81'><span class='gform-field-label__text'>how many hours<\/span><\/label><div class='gfield_description' id='gfield_description_35_81'>How many hours, on average, do you sleep?  <\/div><div class='ginput_container ginput_container_text'><input name='input_81' id='input_35_81' type='text' value='' class='large'  aria-describedby=\"gfield_description_35_81\" tabindex='167'   aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_35_134\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><\/br><\/li><li id=\"field_35_82\" class=\"gfield gfield--type-radio gfield--type-choice gf_list_inline field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Do you experience stress?<\/span><\/label><div class='gfield_description' id='gfield_description_35_82'>On scale 1 - 10:  <\/div><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_35_82'>\n\t\t\t<li class='gchoice gchoice_35_82_0'>\n\t\t\t\t<input name='input_82' type='radio' value='1'  id='choice_35_82_0' tabindex='168'   \/>\n\t\t\t\t<label for='choice_35_82_0' id='label_35_82_0' class='gform-field-label gform-field-label--type-inline'>1<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_35_82_1'>\n\t\t\t\t<input name='input_82' type='radio' value='2'  id='choice_35_82_1' tabindex='169'   \/>\n\t\t\t\t<label for='choice_35_82_1' id='label_35_82_1' class='gform-field-label gform-field-label--type-inline'>2<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_35_82_2'>\n\t\t\t\t<input name='input_82' type='radio' value='3'  id='choice_35_82_2' tabindex='170'   \/>\n\t\t\t\t<label for='choice_35_82_2' id='label_35_82_2' class='gform-field-label gform-field-label--type-inline'>3<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_35_82_3'>\n\t\t\t\t<input name='input_82' type='radio' value='4'  id='choice_35_82_3' tabindex='171'   \/>\n\t\t\t\t<label for='choice_35_82_3' id='label_35_82_3' class='gform-field-label gform-field-label--type-inline'>4<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_35_82_4'>\n\t\t\t\t<input name='input_82' type='radio' value='5'  id='choice_35_82_4' tabindex='172'   \/>\n\t\t\t\t<label for='choice_35_82_4' id='label_35_82_4' class='gform-field-label gform-field-label--type-inline'>5<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_35_82_5'>\n\t\t\t\t<input name='input_82' type='radio' value='6'  id='choice_35_82_5' tabindex='173'   \/>\n\t\t\t\t<label for='choice_35_82_5' id='label_35_82_5' class='gform-field-label gform-field-label--type-inline'>6<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_35_82_6'>\n\t\t\t\t<input name='input_82' type='radio' value='7'  id='choice_35_82_6' tabindex='174'   \/>\n\t\t\t\t<label for='choice_35_82_6' id='label_35_82_6' class='gform-field-label gform-field-label--type-inline'>7<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_35_82_7'>\n\t\t\t\t<input name='input_82' type='radio' value='8'  id='choice_35_82_7' tabindex='175'   \/>\n\t\t\t\t<label for='choice_35_82_7' id='label_35_82_7' class='gform-field-label gform-field-label--type-inline'>8<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_35_82_8'>\n\t\t\t\t<input name='input_82' type='radio' value='9'  id='choice_35_82_8' tabindex='176'   \/>\n\t\t\t\t<label for='choice_35_82_8' id='label_35_82_8' class='gform-field-label gform-field-label--type-inline'>9<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_35_82_9'>\n\t\t\t\t<input name='input_82' type='radio' value='10'  id='choice_35_82_9' tabindex='177'   \/>\n\t\t\t\t<label for='choice_35_82_9' id='label_35_82_9' class='gform-field-label gform-field-label--type-inline'>10<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_35_135\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><\/br><\/li><li id=\"field_35_104\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><\/br><hr><strong>General questions regarding current fitness:<\/strong><\/br><\/br><\/li><li id=\"field_35_91\" class=\"gfield gfield--type-radio gfield--type-choice gf_list_inline field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>How has your fitness been in the past few years?<\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_35_91'>\n\t\t\t<li class='gchoice gchoice_35_91_0'>\n\t\t\t\t<input name='input_91' type='radio' value='bad'  id='choice_35_91_0' tabindex='178'   \/>\n\t\t\t\t<label for='choice_35_91_0' id='label_35_91_0' class='gform-field-label gform-field-label--type-inline'>Poor<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_35_91_1'>\n\t\t\t\t<input name='input_91' type='radio' value='moderate'  id='choice_35_91_1' tabindex='179'   \/>\n\t\t\t\t<label for='choice_35_91_1' id='label_35_91_1' class='gform-field-label gform-field-label--type-inline'>Mediocre<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_35_91_2'>\n\t\t\t\t<input name='input_91' type='radio' value='normal'  id='choice_35_91_2' tabindex='180'   \/>\n\t\t\t\t<label for='choice_35_91_2' id='label_35_91_2' class='gform-field-label gform-field-label--type-inline'>Normal<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_35_91_3'>\n\t\t\t\t<input name='input_91' type='radio' value='good'  id='choice_35_91_3' tabindex='181'   \/>\n\t\t\t\t<label for='choice_35_91_3' id='label_35_91_3' class='gform-field-label gform-field-label--type-inline'>Good<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_35_92\" class=\"gfield gfield--type-radio gfield--type-choice gf_list_inline field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Do you feel that you have enough energy?<\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_35_92'>\n\t\t\t<li class='gchoice gchoice_35_92_0'>\n\t\t\t\t<input name='input_92' type='radio' value='yes'  id='choice_35_92_0' tabindex='182'   \/>\n\t\t\t\t<label for='choice_35_92_0' id='label_35_92_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_35_92_1'>\n\t\t\t\t<input name='input_92' type='radio' value='no'  id='choice_35_92_1' tabindex='183'   \/>\n\t\t\t\t<label for='choice_35_92_1' id='label_35_92_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_35_92_2'>\n\t\t\t\t<input name='input_92' type='radio' value='moderate'  id='choice_35_92_2' tabindex='184'   \/>\n\t\t\t\t<label for='choice_35_92_2' id='label_35_92_2' class='gform-field-label gform-field-label--type-inline'>Mediocore<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_35_93\" class=\"gfield gfield--type-radio gfield--type-choice gf_list_inline field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>How is your general feeling of wellbeing?<\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_35_93'>\n\t\t\t<li class='gchoice gchoice_35_93_0'>\n\t\t\t\t<input name='input_93' type='radio' value='bad'  id='choice_35_93_0' tabindex='185'   \/>\n\t\t\t\t<label for='choice_35_93_0' id='label_35_93_0' class='gform-field-label gform-field-label--type-inline'>Poor<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_35_93_1'>\n\t\t\t\t<input name='input_93' type='radio' value='moderate'  id='choice_35_93_1' tabindex='186'   \/>\n\t\t\t\t<label for='choice_35_93_1' id='label_35_93_1' class='gform-field-label gform-field-label--type-inline'>Mediocore<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_35_93_2'>\n\t\t\t\t<input name='input_93' type='radio' value='good'  id='choice_35_93_2' tabindex='187'   \/>\n\t\t\t\t<label for='choice_35_93_2' id='label_35_93_2' class='gform-field-label gform-field-label--type-inline'>Good<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_35_94\" class=\"gfield gfield--type-radio gfield--type-choice gf_list_inline field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>How much time do you spend exercising per day (walking, biking etc. in minutes)? <\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_35_94'>\n\t\t\t<li class='gchoice gchoice_35_94_0'>\n\t\t\t\t<input name='input_94' type='radio' value='&lt;15'  id='choice_35_94_0' tabindex='188'   \/>\n\t\t\t\t<label for='choice_35_94_0' id='label_35_94_0' class='gform-field-label gform-field-label--type-inline'>&lt;15<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_35_94_1'>\n\t\t\t\t<input name='input_94' type='radio' value='15-30'  id='choice_35_94_1' tabindex='189'   \/>\n\t\t\t\t<label for='choice_35_94_1' id='label_35_94_1' class='gform-field-label gform-field-label--type-inline'>15-30<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_35_94_2'>\n\t\t\t\t<input name='input_94' type='radio' value='30-60'  id='choice_35_94_2' tabindex='190'   \/>\n\t\t\t\t<label for='choice_35_94_2' id='label_35_94_2' class='gform-field-label gform-field-label--type-inline'>30-60<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_35_94_3'>\n\t\t\t\t<input name='input_94' type='radio' value='&gt;60'  id='choice_35_94_3' tabindex='191'   \/>\n\t\t\t\t<label for='choice_35_94_3' id='label_35_94_3' class='gform-field-label gform-field-label--type-inline'>&gt;60<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_35_95\" class=\"gfield gfield--type-radio gfield--type-choice gf_list_inline field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Do you exercise?<\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_35_95'>\n\t\t\t<li class='gchoice gchoice_35_95_0'>\n\t\t\t\t<input name='input_95' type='radio' value='yes'  id='choice_35_95_0' tabindex='192'   \/>\n\t\t\t\t<label for='choice_35_95_0' id='label_35_95_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_35_95_1'>\n\t\t\t\t<input name='input_95' type='radio' value='no'  id='choice_35_95_1' tabindex='193'   \/>\n\t\t\t\t<label for='choice_35_95_1' id='label_35_95_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_35_96\" class=\"gfield gfield--type-text field_sublabel_below gfield--has-description field_description_above hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_35_96'><span class='gform-field-label__text'>sport_well<\/span><\/label><div class='gfield_description' id='gfield_description_35_96'>If yes, what kind?  <\/div><div class='ginput_container ginput_container_text'><input name='input_96' id='input_35_96' type='text' value='' class='large'  aria-describedby=\"gfield_description_35_96\" tabindex='194'   aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_35_137\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><\/br><\/li><li id=\"field_35_97\" class=\"gfield gfield--type-text field_sublabel_below gfield--has-description field_description_above hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_35_97'><span class='gform-field-label__text'>sport_how much<\/span><\/label><div class='gfield_description' id='gfield_description_35_97'>How many times per week<\/div><div class='ginput_container ginput_container_text'><input name='input_97' id='input_35_97' type='text' value='' class='large'  aria-describedby=\"gfield_description_35_97\" tabindex='195'   aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_35_138\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><\/br><\/li><li id=\"field_35_103\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><\/br><hr><strong>57. Goal: What do you hope to achieve with lifestyle coaching?<\/strong><\/li><li id=\"field_35_141\" class=\"gfield gfield--type-textarea field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label screen-reader-text' for='input_35_141'><span class='gform-field-label__text'><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_141' id='input_35_141' class='textarea medium' tabindex='196'     aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_35_105\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><\/br><hr><strong>Only for women:<\/strong><\/br><\/br><\/li><li id=\"field_35_85\" class=\"gfield gfield--type-radio gfield--type-choice gf_list_inline field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Are you in the menopause?<\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_35_85'>\n\t\t\t<li class='gchoice gchoice_35_85_0'>\n\t\t\t\t<input name='input_85' type='radio' value='yes'  id='choice_35_85_0' tabindex='197'   \/>\n\t\t\t\t<label for='choice_35_85_0' id='label_35_85_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_35_85_1'>\n\t\t\t\t<input name='input_85' type='radio' value='no'  id='choice_35_85_1' tabindex='198'   \/>\n\t\t\t\t<label for='choice_35_85_1' id='label_35_85_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_35_86\" class=\"gfield gfield--type-radio gfield--type-choice gf_list_inline field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>If yes, since when?<\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_35_86'>\n\t\t\t<li class='gchoice gchoice_35_86_0'>\n\t\t\t\t<input name='input_86' type='radio' value='&lt;1 year'  id='choice_35_86_0' tabindex='199'   \/>\n\t\t\t\t<label for='choice_35_86_0' id='label_35_86_0' class='gform-field-label gform-field-label--type-inline'>&lt;1 year<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_35_86_1'>\n\t\t\t\t<input name='input_86' type='radio' value='1-2 years'  id='choice_35_86_1' tabindex='200'   \/>\n\t\t\t\t<label for='choice_35_86_1' id='label_35_86_1' class='gform-field-label gform-field-label--type-inline'>1-2 years<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_35_86_2'>\n\t\t\t\t<input name='input_86' type='radio' value='2-5 years'  id='choice_35_86_2' tabindex='201'   \/>\n\t\t\t\t<label for='choice_35_86_2' id='label_35_86_2' class='gform-field-label gform-field-label--type-inline'>2-5 years<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_35_86_3'>\n\t\t\t\t<input name='input_86' type='radio' value='5-10 years'  id='choice_35_86_3' tabindex='202'   \/>\n\t\t\t\t<label for='choice_35_86_3' id='label_35_86_3' class='gform-field-label gform-field-label--type-inline'>5-10 years<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_35_86_4'>\n\t\t\t\t<input name='input_86' type='radio' value='10 years&gt;'  id='choice_35_86_4' tabindex='203'   \/>\n\t\t\t\t<label for='choice_35_86_4' id='label_35_86_4' class='gform-field-label gform-field-label--type-inline'>10 years&gt;<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_35_87\" class=\"gfield gfield--type-radio gfield--type-choice gf_list_inline field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Do you have (or had) problems with your menstruations?<\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_35_87'>\n\t\t\t<li class='gchoice gchoice_35_87_0'>\n\t\t\t\t<input name='input_87' type='radio' value='yes'  id='choice_35_87_0' tabindex='204'   \/>\n\t\t\t\t<label for='choice_35_87_0' id='label_35_87_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_35_87_1'>\n\t\t\t\t<input name='input_87' type='radio' value='no'  id='choice_35_87_1' tabindex='205'   \/>\n\t\t\t\t<label for='choice_35_87_1' id='label_35_87_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_35_88\" class=\"gfield gfield--type-text gf_list_inline field_sublabel_below gfield--has-description field_description_above hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_35_88'><span class='gform-field-label__text'>menstruation_yes<\/span><\/label><div class='gfield_description' id='gfield_description_35_88'>If yes, what kind of problems?  <\/div><div class='ginput_container ginput_container_text'><input name='input_88' id='input_35_88' type='text' value='' class='large'  aria-describedby=\"gfield_description_35_88\" tabindex='206'   aria-invalid=\"false\"   \/><\/div><\/li><\/ul><\/div>\n        <div class='gform-footer gform_footer top_label'> <button type='submit' id='gform_submit_button_35' class='gform_button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='submit' 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value='' \/>\n            \n        <\/div>\n                        <\/form>\n                        <\/div>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>LSC Nutrition questionnaire<\/p>\n","protected":false},"author":10,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-5694","page","type-page","status-publish","hentry"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.2 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>LSC Nutrition Anamnesis | Allurion Kliniek Amersfoort<\/title>\n<meta name=\"description\" content=\"With a nutritional history, or eating report, the Allurion Clinic maps out your diet for the Elipse Gastric Balloon program.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, 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