{"id":253,"date":"2019-10-03T16:37:22","date_gmt":"2019-10-03T20:37:22","guid":{"rendered":"https:\/\/nutritionyourweighinc.com\/\/?page_id=253"},"modified":"2019-10-04T16:17:33","modified_gmt":"2019-10-04T20:17:33","slug":"assessment","status":"publish","type":"page","link":"https:\/\/nutritionyourweighinc.com\/assessment\/","title":{"rendered":"Assessment Form"},"content":{"rendered":"<p>[fusion_builder_container hundred_percent=&#8221;no&#8221; hundred_percent_height=&#8221;no&#8221; hundred_percent_height_scroll=&#8221;no&#8221; hundred_percent_height_center_content=&#8221;yes&#8221; equal_height_columns=&#8221;no&#8221; menu_anchor=&#8221;&#8221; hide_on_mobile=&#8221;small-visibility,medium-visibility,large-visibility&#8221; status=&#8221;published&#8221; publish_date=&#8221;&#8221; class=&#8221;&#8221; id=&#8221;&#8221; background_color=&#8221;&#8221; background_image=&#8221;&#8221; background_position=&#8221;center center&#8221; background_repeat=&#8221;no-repeat&#8221; 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rule_size=&#8221;&#8221; rule_color=&#8221;&#8221; hide_on_mobile=&#8221;small-visibility,medium-visibility,large-visibility&#8221; class=&#8221;&#8221; id=&#8221;&#8221;]<script type=\"text\/javascript\">var gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,initializeOnLoaded:function(o){gform.domLoaded&&gform.scriptsLoaded?o():!gform.domLoaded&&gform.scriptsLoaded?window.addEventListener(\"DOMContentLoaded\",o):document.addEventListener(\"gform_main_scripts_loaded\",o)},hooks:{action:{},filter:{}},addAction:function(o,n,r,t){gform.addHook(\"action\",o,n,r,t)},addFilter:function(o,n,r,t){gform.addHook(\"filter\",o,n,r,t)},doAction:function(o){gform.doHook(\"action\",o,arguments)},applyFilters:function(o){return gform.doHook(\"filter\",o,arguments)},removeAction:function(o,n){gform.removeHook(\"action\",o,n)},removeFilter:function(o,n,r){gform.removeHook(\"filter\",o,n,r)},addHook:function(o,n,r,t,i){null==gform.hooks[o][n]&&(gform.hooks[o][n]=[]);var e=gform.hooks[o][n];null==i&&(i=n+\"_\"+e.length),gform.hooks[o][n].push({tag:i,callable:r,priority:t=null==t?10:t})},doHook:function(n,o,r){var t;if(r=Array.prototype.slice.call(r,1),null!=gform.hooks[n][o]&&((o=gform.hooks[n][o]).sort(function(o,n){return o.priority-n.priority}),o.forEach(function(o){\"function\"!=typeof(t=o.callable)&&(t=window[t]),\"action\"==n?t.apply(null,r):r[0]=t.apply(null,r)})),\"filter\"==n)return r[0]},removeHook:function(o,n,t,i){var r;null!=gform.hooks[o][n]&&(r=(r=gform.hooks[o][n]).filter(function(o,n,r){return!!(null!=i&&i!=o.tag||null!=t&&t!=o.priority)}),gform.hooks[o][n]=r)}});<\/script>\n                <div class='gf_browser_safari gform_wrapper gform_legacy_markup_wrapper' id='gform_wrapper_5' style='display:none'><div id='gf_5' class='gform_anchor' tabindex='-1'><\/div><form method='post' enctype='multipart\/form-data'  id='gform_5'  action='\/wp-json\/wp\/v2\/pages\/253#gf_5' >\n        <div id='gf_progressbar_wrapper_5' class='gf_progressbar_wrapper'>\n        \t<h3 class=\"gf_progressbar_title\">Step <span class='gf_step_current_page'>1<\/span> of <span class='gf_step_page_count'>4<\/span>\n        \t<\/h3>\n            <div class='gf_progressbar gf_progressbar_blue' aria-hidden='true'>\n                <div class='gf_progressbar_percentage percentbar_blue percentbar_25' style='width:25%;'><span>25%<\/span><\/div>\n            <\/div><\/div>\n                        <div class='gform_body gform-body'><div id='gform_page_5_1' class='gform_page' >\n                                    <div class='gform_page_fields'><ul id='gform_fields_5' class='gform_fields top_label form_sublabel_below description_above'><li id=\"field_5_27\"  class=\"gfield gsection field_sublabel_below field_description_above gfield_visibility_visible\"  data-js-reload=\"field_5_27\"><h2 class=\"gsection_title\">Your information...<\/h2><\/li><li id=\"field_5_1\"  class=\"gfield gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\"  data-js-reload=\"field_5_1\"><label class='gfield_label gfield_label_before_complex'  >Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_complex ginput_container no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name' id='input_5_1'>\n                            \n                            <span id='input_5_1_3_container' class='name_first' >\n                                                    <input type='text' name='input_1.3' id='input_5_1_3' value=''   aria-required='true'     \/>\n                                                    <label for='input_5_1_3' >First<\/label>\n                                                <\/span>\n                            \n                            <span id='input_5_1_6_container' class='name_last' >\n                                                    <input type='text' name='input_1.6' id='input_5_1_6' value=''   aria-required='true'     \/>\n                                                    <label for='input_5_1_6' >Last<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/li><li id=\"field_5_2\"  class=\"gfield gf_left_half gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\"  data-js-reload=\"field_5_2\"><label class='gfield_label' for='input_5_2' >Email<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_2' id='input_5_2' type='text' value='' class='medium'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/li><li id=\"field_5_3\"  class=\"gfield gf_right_half gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\"  data-js-reload=\"field_5_3\"><label class='gfield_label' for='input_5_3' >Phone<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_3' id='input_5_3' type='text' value='' class='medium'   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_5_7\"  class=\"gfield gf_left_half field_sublabel_below field_description_above gfield_visibility_visible\"  data-js-reload=\"field_5_7\"><label class='gfield_label' for='input_5_7' >Age<\/label><div class='ginput_container ginput_container_text'><input name='input_7' id='input_5_7' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_5_9\"  class=\"gfield gf_right_half field_sublabel_below field_description_above gfield_visibility_visible\"  data-js-reload=\"field_5_9\"><label class='gfield_label' for='input_5_9' >Height<\/label><div class='ginput_container ginput_container_text'><input name='input_9' id='input_5_9' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><\/ul>\n                    <\/div>\n                    <div class='gform_page_footer top_label'>\n                         <input type='button' id='gform_next_button_5_28' class='gform_next_button button' value='Next'  onclick='jQuery(\"#gform_target_page_number_5\").val(\"2\");  jQuery(\"#gform_5\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_5\").val(\"2\");  jQuery(\"#gform_5\").trigger(\"submit\",[true]); } ' \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_5_2' class='gform_page' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <ul id='gform_fields_5_2' class='gform_fields top_label form_sublabel_below description_above'><li id=\"field_5_29\"  class=\"gfield gsection field_sublabel_below field_description_above gfield_visibility_visible\"  data-js-reload=\"field_5_29\"><h2 class=\"gsection_title\">What you&#039;re looking for...<\/h2><\/li><li id=\"field_5_12\"  class=\"gfield field_sublabel_below field_description_above gfield_visibility_visible\"  data-js-reload=\"field_5_12\"><label class='gfield_label' for='input_5_12' >Do you want to see changes in your body weight or composition?<\/label><div class='gfield_description' id='gfield_description_5_12'>If so, describe the types of changes would you like to see.<\/div><div class='ginput_container ginput_container_textarea'><textarea name='input_12' id='input_5_12' class='textarea small'  aria-describedby=\"gfield_description_5_12\"    aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_5_13\"  class=\"gfield field_sublabel_below field_description_above gfield_visibility_visible\"  data-js-reload=\"field_5_13\"><label class='gfield_label' for='input_5_13' >What are your health, lifestyle and dietary goals?<\/label><div class='gfield_description' id='gfield_description_5_13'>The more details the better.<\/div><div class='ginput_container ginput_container_textarea'><textarea name='input_13' id='input_5_13' class='textarea small'  aria-describedby=\"gfield_description_5_13\"    aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_5_14\"  class=\"gfield field_sublabel_below field_description_above gfield_visibility_visible\"  data-js-reload=\"field_5_14\"><label class='gfield_label' for='input_5_14' >Have you ever followed a diet?<\/label><div class='gfield_description' id='gfield_description_5_14'>If so, describe your experience.<\/div><div class='ginput_container ginput_container_textarea'><textarea name='input_14' id='input_5_14' class='textarea small'  aria-describedby=\"gfield_description_5_14\"    aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_5_15\"  class=\"gfield field_sublabel_below field_description_above gfield_visibility_visible\"  data-js-reload=\"field_5_15\"><label class='gfield_label' for='input_5_15' >What do you hope to achieve through working with a nutritionist?<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_15' id='input_5_15' class='textarea small'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_5_16\"  class=\"gfield field_sublabel_below field_description_above gfield_visibility_visible\"  data-js-reload=\"field_5_16\"><label class='gfield_label' for='input_5_16' >Do you exercise regularly?<\/label><div class='ginput_container ginput_container_select'><select name='input_16' id='input_5_16' class='medium gfield_select'     aria-invalid=\"false\" ><option value='No' >No<\/option><option value='Yes' >Yes<\/option><\/select><\/div><\/li><li id=\"field_5_17\"  class=\"gfield field_sublabel_below field_description_above gfield_visibility_visible\"  data-js-reload=\"field_5_17\"><label class='gfield_label' for='input_5_17' >How often and what type of exercise?<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_17' id='input_5_17' class='textarea small'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_5_18\"  class=\"gfield field_sublabel_below field_description_above gfield_visibility_visible\"  data-js-reload=\"field_5_18\"><label class='gfield_label' for='input_5_18' >Do you feel your current diet is healthy?<\/label><div class='ginput_container ginput_container_select'><select name='input_18' id='input_5_18' class='medium gfield_select'     aria-invalid=\"false\" ><option value='Yes' >Yes<\/option><option value='No' >No<\/option><\/select><\/div><\/li><li id=\"field_5_19\"  class=\"gfield field_sublabel_below field_description_above gfield_visibility_visible\"  data-js-reload=\"field_5_19\"><label class='gfield_label' for='input_5_19' >What do you think your current diet is lacking?<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_19' id='input_5_19' class='textarea small'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_5_20\"  class=\"gfield field_sublabel_below field_description_above gfield_visibility_visible\"  data-js-reload=\"field_5_20\"><label class='gfield_label' for='input_5_20' >Do you have any digestive issues?<\/label><div class='ginput_container ginput_container_select'><select name='input_20' id='input_5_20' class='medium gfield_select'     aria-invalid=\"false\" ><option value='No' >No<\/option><option value='Yes' >Yes<\/option><\/select><\/div><\/li><li id=\"field_5_21\"  class=\"gfield field_sublabel_below field_description_above gfield_visibility_visible\"  data-js-reload=\"field_5_21\"><label class='gfield_label' for='input_5_21' >What kind and how often?<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_21' id='input_5_21' class='textarea small'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_5_22\"  class=\"gfield field_sublabel_below field_description_above gfield_visibility_visible\"  data-js-reload=\"field_5_22\"><label class='gfield_label' for='input_5_22' >Do you have a bowel movement every day?<\/label><div class='ginput_container ginput_container_select'><select name='input_22' id='input_5_22' class='medium gfield_select'     aria-invalid=\"false\" ><option value='Yes' >Yes<\/option><option value='No' >No<\/option><\/select><\/div><\/li><li id=\"field_5_23\"  class=\"gfield field_sublabel_below field_description_above gfield_visibility_visible\"  data-js-reload=\"field_5_23\"><label class='gfield_label' for='input_5_23' >How often?<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_23' id='input_5_23' class='textarea small'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_5_24\"  class=\"gfield field_sublabel_below field_description_above gfield_visibility_visible gsurvey-survey-field \"  data-field-class=\"gsurvey-survey-field\" data-js-reload=\"field_5_24\"><label class='gfield_label'  >Rate your average daily energy on a scale of 1 to 5.<\/label><div class='gfield_description' id='gfield_description_5_24'>1 being you're constantly dragging and 5 being you've had 10 cups of coffee.<\/div><div class='ginput_container ginput_container_likert'><table class='gsurvey-likert' id='input_5_24'><thead><tr><th scope='col' class='gsurvey-likert-choice-label'>1<\/th><th scope='col' class='gsurvey-likert-choice-label'>2<\/th><th scope='col' class='gsurvey-likert-choice-label'>3<\/th><th scope='col' class='gsurvey-likert-choice-label'>4<\/th><th scope='col' class='gsurvey-likert-choice-label'>5<\/th><\/tr><\/thead><tbody><tr><td data-label='1' class='gsurvey-likert-choice'><input name='input_24' type='radio' value='glikertcol244eaae548'  id='choice_5_24_1'   \/><\/td><td data-label='2' class='gsurvey-likert-choice'><input name='input_24' type='radio' value='glikertcol24f6db3731'  id='choice_5_24_2'   \/><\/td><td data-label='3' class='gsurvey-likert-choice'><input name='input_24' type='radio' value='glikertcol248715b94a'  id='choice_5_24_3'   \/><\/td><td data-label='4' class='gsurvey-likert-choice'><input name='input_24' type='radio' value='glikertcol24e611ae43'  id='choice_5_24_4'   \/><\/td><td data-label='5' class='gsurvey-likert-choice'><input name='input_24' type='radio' value='glikertcol24106819c1'  id='choice_5_24_5'   \/><\/td><\/tr><\/tbody><\/table><\/div><\/li><\/ul>\n                    <\/div>\n                    <div class='gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_5_26' class='gform_previous_button button' value='Previous'  onclick='jQuery(\"#gform_target_page_number_5\").val(\"1\");  jQuery(\"#gform_5\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_5\").val(\"1\");  jQuery(\"#gform_5\").trigger(\"submit\",[true]); } ' \/> <input type='button' id='gform_next_button_5_26' class='gform_next_button button' value='Next'  onclick='jQuery(\"#gform_target_page_number_5\").val(\"3\");  jQuery(\"#gform_5\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_5\").val(\"3\");  jQuery(\"#gform_5\").trigger(\"submit\",[true]); } ' \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_5_3' class='gform_page' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <ul id='gform_fields_5_3' class='gform_fields top_label form_sublabel_below description_above'><li id=\"field_5_25\"  class=\"gfield gsection field_sublabel_below field_description_above gfield_visibility_visible\"  data-js-reload=\"field_5_25\"><h2 class=\"gsection_title\">Tell me about your current diet...<\/h2><\/li><li id=\"field_5_30\"  class=\"gfield field_sublabel_below field_description_above gfield_visibility_visible\"  data-js-reload=\"field_5_30\"><label class='gfield_label' for='input_5_30' >How many times do you eat per day?<\/label><div class='ginput_container ginput_container_text'><input name='input_30' id='input_5_30' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_5_31\"  class=\"gfield field_sublabel_below field_description_above gfield_visibility_visible\"  data-js-reload=\"field_5_31\"><label class='gfield_label' for='input_5_31' >Describe your typical breakfast &amp; at what time you eat it.<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_31' id='input_5_31' class='textarea small'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_5_32\"  class=\"gfield field_sublabel_below field_description_above gfield_visibility_visible\"  data-js-reload=\"field_5_32\"><label class='gfield_label' for='input_5_32' >Describe your typical lunch &amp; at what time you eat it.<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_32' id='input_5_32' class='textarea small'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_5_33\"  class=\"gfield field_sublabel_below field_description_above gfield_visibility_visible\"  data-js-reload=\"field_5_33\"><label class='gfield_label' for='input_5_33' >Describe your typical dinner &amp; at what time you eat it.<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_33' id='input_5_33' class='textarea small'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_5_34\"  class=\"gfield field_sublabel_below field_description_above gfield_visibility_visible\"  data-js-reload=\"field_5_34\"><label class='gfield_label' for='input_5_34' >Describe your typical snacks &amp; at what times you eat them.<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_34' id='input_5_34' class='textarea small'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_5_36\"  class=\"gfield field_sublabel_below field_description_above gfield_visibility_visible\"  data-js-reload=\"field_5_36\"><label class='gfield_label' for='input_5_36' >How many meals per week do you eat out?<\/label><div class='ginput_container ginput_container_select'><select name='input_36' id='input_5_36' class='medium gfield_select'     aria-invalid=\"false\" ><option value='0' >0<\/option><option value='1-2' >1-2<\/option><option value='3-4' >3-4<\/option><option value='4 or more' >4 or more<\/option><\/select><\/div><\/li><li id=\"field_5_37\"  class=\"gfield field_sublabel_below field_description_above gfield_visibility_visible\"  data-js-reload=\"field_5_37\"><label class='gfield_label' for='input_5_37' >What is the most common meal you will eat out for and why?<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_37' id='input_5_37' class='textarea small'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><\/ul>\n                    <\/div>\n                    <div class='gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_5_38' class='gform_previous_button button' value='Previous'  onclick='jQuery(\"#gform_target_page_number_5\").val(\"2\");  jQuery(\"#gform_5\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_5\").val(\"2\");  jQuery(\"#gform_5\").trigger(\"submit\",[true]); } ' \/> <input type='button' id='gform_next_button_5_38' class='gform_next_button button' value='Next'  onclick='jQuery(\"#gform_target_page_number_5\").val(\"4\");  jQuery(\"#gform_5\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_5\").val(\"4\");  jQuery(\"#gform_5\").trigger(\"submit\",[true]); } ' \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_5_4' class='gform_page' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <ul id='gform_fields_5_4' class='gform_fields top_label form_sublabel_below description_above'><li id=\"field_5_39\"  class=\"gfield gsection field_sublabel_below field_description_above gfield_visibility_visible\"  data-js-reload=\"field_5_39\"><h2 class=\"gsection_title\">Let&#039;s talk about meal planning...<\/h2><\/li><li id=\"field_5_40\"  class=\"gfield field_sublabel_below field_description_above gfield_visibility_visible\"  data-js-reload=\"field_5_40\"><label class='gfield_label' for='input_5_40' >What is your motivation for seeking out a meal plan?<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_40' id='input_5_40' class='textarea small'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_5_41\"  class=\"gfield field_sublabel_below field_description_above gfield_visibility_visible\"  data-js-reload=\"field_5_41\"><label class='gfield_label' for='input_5_41' >Are there any foods you will not eat due to sensitivities, allergies, or religious reasons?<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_41' id='input_5_41' class='textarea small'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_5_42\"  class=\"gfield field_sublabel_below field_description_above gfield_visibility_visible\"  data-js-reload=\"field_5_42\"><label class='gfield_label' for='input_5_42' >How much time would you ideally want to spend in the kitchen per day?<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_42' id='input_5_42' class='textarea small'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_5_43\"  class=\"gfield field_sublabel_below field_description_above gfield_visibility_visible\"  data-js-reload=\"field_5_43\"><label class='gfield_label' for='input_5_43' >What are some of your favorite foods to eat?<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_43' id='input_5_43' class='textarea small'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_5_45\"  class=\"gfield field_sublabel_below field_description_above gfield_visibility_visible\"  data-js-reload=\"field_5_45\"><label class='gfield_label' for='input_5_45' >What excites you about having or following a custom meal plan?<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_45' id='input_5_45' class='textarea small'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_5_46\"  class=\"gfield field_sublabel_below field_description_above gfield_visibility_visible\"  data-js-reload=\"field_5_46\"><label class='gfield_label' for='input_5_46' >Is there anything that scares you or intimidates you about following a meal plan?<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_46' id='input_5_46' class='textarea small'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_5_47\"  class=\"gfield field_sublabel_below field_description_above gfield_visibility_visible\"  data-js-reload=\"field_5_47\"><label class='gfield_label' for='input_5_47' >Is there anything else about yourself that you would like to share with me to help in building your meal plan?<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_47' id='input_5_47' class='textarea small'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_5_49\"  class=\"gfield field_sublabel_below field_description_above gfield_visibility_visible\"  data-js-reload=\"field_5_49\"><label class='gfield_label gfield_label_before_complex'  >Which food prep style best describes you?<\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_5_49'><li class='gchoice gchoice_5_49_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_49.1' type='checkbox'  value='I like to prep food in advance and eat the same meals for a few days'  id='choice_5_49_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_5_49_1' id='label_5_49_1'>I like to prep food in advance and eat the same meals for a few days<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_5_49_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_49.2' type='checkbox'  value='I want to spend more time cooking and have different meals each day'  id='choice_5_49_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_5_49_2' id='label_5_49_2'>I want to spend more time cooking and have different meals each day<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_5_5\"  class=\"gfield field_sublabel_below field_description_above gfield_visibility_visible\"  data-js-reload=\"field_5_5\"><label class='gfield_label' for='input_5_5' >Additional Comments or Questions<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_5' id='input_5_5' class='textarea small'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li 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