[vc_row][vc_column] - Step 1 of 14Terms of Service *I have read and agree to the terms of service listed below. General Terms and Conditions PLEASE READ THESE TERMS AND CONDITIONS OF USE CAREFULLY BEFORE USING THIS SITE/SERVICE. By using this site, you signify your assent to these Terms and Conditions. If you do not agree to all of these Terms and Conditions of use, do not use this site! Optimal Nutrition Protocol(Trademark Pending) ("ONP") may revise and update these Terms and Conditions at any time. Your continued usage of the ONP will mean you accept those changes. ONP Does Not Provide Medical Advice The content portrayed on ONP Reports or it's website including but not restricted to text, graphics, images, information, etc., are for information purposes only. The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read here. Use of Materials Any use of the materials not expressly permitted by these Terms and Conditions is a breach of these Terms and Conditions and may violate copyright, trademark, and other laws. Content and features are subject to change or termination without notice in the editorial discretion of ONP. All rights not expressly granted herein are reserved to ONP. If you violate any of these Terms and Conditions, your permission to use the materials automatically terminates and you must immediately destroy any copies you have made of any portion of the materials. Liability of ONP The use of ONP and it's content is at your own risk. The report and the content are provided on an "as is" basis. ONP TO THE FULLEST EXTENT PERMITTED BY LAW, DISCLAIM ALL WARRANTIES, EITHER EXPRESS OR IMPLIED, STATUTORY OR OTHERWISE, INCLUDING BUT NOT LIMITED TO THE IMPLIED WARRANTIES OF MERCHANTABILITY, NON-INFRINGEMENT OF THIRD PARTIES' RIGHTS, AND FITNESS FOR PARTICULAR PURPOSE. Without limiting the foregoing, ONP make no representations or warranties about the following: The accuracy, reliability, completeness, currentness, or timeliness of the Content, software, text, graphics, links, or communications provided on or through the use of the ONP. In no event shall ONP be liable for any damages (including, without limitation, incidental and consequential damages, personal injury/wrongful death, lost profits, or damages resulting from lost data or business interruption) resulting from the use of or inability to use the ONP, whether based on warranty, contract, tort, or any other legal theory, and whether or not ONP are advised of the possibility of such damages. ONP is not liable for any personal injury, including death, caused by your use or misuse of the Site, Content, or Public Areas. Any claims arising in connection with your use of the Site, any Content, or the Public Areas must be brought within one (1) year of the date of the event giving rise to such action occurred. Remedies under these Terms and Conditions are exclusive and are limited to those expressly provided for in these Terms and Conditions. Access to ONP Counsellors: Access to ONP Counsellors ("Counsellors") will be available only based on the package chosen. Monthly plan members will receive 3 fifteen minute reviews at the start, middle and end of their program. They will also get access to email support with an estimated response time of 24-48 hours unless there's an emergency. Quarterly plan members will receive 1 half an hour review every month and access to WhatsApp support. Please note that WhatsApp support is accessible only between 10 am to 7 pm IST and any message sent outside these timings will be responded to only on the next day. Please note that access to counsellors will be available only from Monday to Saturday. They will not be reachable on Sundays unless in case of emergencies. Payment Terms: ONP does not accept any partial payment for it's plan. Payment once made is not refundable. The membership is Non-Transferable.NextInformed User Consent I hereby consent to ONP and it’s partners for the drawing of a blood sample for the purpose of measuring my biomarkers to perform assessment of my lifestyle conditions and possible disorders. I accept that services, including counseling/explaining of results, might be rendered in a non-private setting. Furthermore, I hereby release and forever discharge for myself, my heirs, executors, administrators and assignees, ONP and their employees, owners and representatives from any and all claims, demands, actions and causes of action, which may result from participation in this program. I understand and accept that: 1. Data derived from this test is to be considered preliminary only and does not constitute any kind of diagnosis. 2. ONP will keep my results strictly confidential and may use it for research purposes. The data will be anonymized and my personal identity will not be revealed. 3. ONP will keep my results strictly confidential and may release my data to a 3rd party vendor, which will anonymize it before using for further studies. 4. The responsibility for initiating a follow-up examination to confirm results and obtain professional advice and medical treatment is mine and not that of ONP. Name *FirstLastDate *GoBackNextPlease read this before you start filling out your questionnaire The questionnaire gives us an insight as to who you are, your preferences and your goals. Each answer affects the outcome of your protocol so be sure to answer only what is applicable to you Beefore you start answering the questionnaire, be sure to have your measurements(height, weight, neck circumference, waist circumference and hip circumference), diet recall and family history of medical conditions ready Do not rush through the questionnaire. Take your time to understand each question and answer it How to take measurements Go BackNextEmail *Date Of Birth *Gender *MaleFemaleOtherWhat gender do you identify with? *Address *Phone Number *Height *Weight *Neck Circumference *Waist Circumference *Hip Circumference *Relationship Status *SingleIn a relationshipMarriedWidow/WidowerApart from wholistic wellness what are you other priorities/goals? *I want to lose fatI want to gain muscleI want to look betterI want to feel betterI want to reverse my current disease conditionI want to change my erratic meal timingsI want a wholistic lifestyle solutionI want to gain weightGo BackNextCurrent ConditionsAre you allergic to any of these environmental allergens? *Artificial jewelleryCatChromiumCobaltCosmeticsDogDustFormaldehydeFungicideGoldHouse Dust MiteInsect StingLatexMoldPerfumePhotographic DevelopersPollenWaterNone of the aboveAre you allergic to any medications? *YesNoMention the medication or the constituent you are allergic to: *What may be some of the health issues you are currently facing? *AIDSAcidityAcne(Body)Acne(Face)Acne(Hands)AllergiesAnemiaArthritisAsthmaBleeding gumsBowel problems(IBD)Bowel problems(IBS)Breast cancerCholesterolColon and rectal cancerColoured patchesDandruffDrynessEar infectionsEmphysemaEpilepsyEye powerEye problemsFatigueGastric troublesGlaucomaHeart attackHeart burnsHigh BPHyperthyroidismHypothyroidismKidney problemsLeukemiaLiver problemsLow BPLung cancerLymphomaMelanomaMenstrual crampsObesityOsteoporosisPCOSPain in bonesPalpitationsPancreatic cancerProstate cancerPulmonary DisorderRashesRecurring cold/fluSkin patchesSore musclesStrokeTooth acheType 1 DiabetesType 2 DiabetesUlcers(Duodenum)Ulcers(Esophageal)Ulcers(Gastric)Ulcers(Peptic)UnderweightNone of the aboveWhat may be some of the health issues you have faced in the past? *AIDSAcidityAcne(Body)Acne(Face)Acne(Hands)AllergiesAnemiaArthritisAsthmaBleeding gumsBowel problems(IBD)Bowel problems(IBS)Breast cancerCholesterolColon and rectal cancerColoured patchesDandruffDrynessEar infectionsEmphysemaEpilepsyEye powerEye problemsFatigueGastric troublesGlaucomaHeart attackHeart burnsHigh BPHyperthyroidismHypothyroidismKidney problemsLeukemiaLiver problemsLow BPLung cancerLymphomaMelanomaMenstrual crampsObesityOsteoporosisPCOSPain in bonesPalpitationsPancreatic cancerProstate cancerPulmonary DisorderRashesRecurring cold/fluSkin patchesSore musclesStrokeTooth acheType 1 DiabetesType 2 DiabetesUlcers(Duodenum)Ulcers(Esophageal)Ulcers(Gastric)Ulcers(Peptic)UnderweightNone of the aboveHistory of past illnesses, surgeries or injuries if any. *For ex., Heart Attack (2 Years back) Have you been regular with vaccine boosters? *YesNoAre you on any medications currently? *YesNoIf yes, please upload your prescription scan copyIf you do not have a scanned copy, please fill in your prescription below.Do you have a family history of any of the following ? *AIDSAcidityAcne(Body)Acne(Face)Acne(Hands)AllergiesAnemiaArthritisAsthmaBleeding gumsBowel problems(IBD)Bowel problems(IBS)Breast cancerCholesterolColon and rectal cancerColoured patchesDandruffDrynessEar infectionsEmphysemaEpilepsyEye powerEye problemsFatigueGastric troublesGlaucomaHeart attackHeart burnsHigh BPHyperthyroidismHypothyroidismKidney problemsLeukemiaLiver problemsLow BPLung cancerLymphomaMelanomaMenstrual crampsObesityOsteoporosisPCOSPain in bonesPalpitationsPancreatic cancerProstate cancerPulmonary DisorderRashesRecurring cold/fluSkin patchesSore musclesStrokeTooth acheType 1 DiabetesType 2 DiabetesUlcers(Duodenum)Ulcers(Esophageal)Ulcers(Gastric)Ulcers(Peptic)UnderweightNone of the aboveOthersPlease Mention Them *Go BackNextCurrent Lifestyle Information - WorkHow would you describe the locality of your residence? *Industrial areaResidential areaWithin 5 km of a garbage dumpsiteWithin 5 km of a highwayWithin 5 km of a stagnant water bodyWhat is your current occupation? *Healthcare Practitioners and Technical Occupations:ChiropractorDentistDietitian or NutritionistOptometristPharmacistPhysicianPhysician AssistantPodiatristRegistered NurseTherapistVeterinarianHealth Technologist or TechnicianOther Healthcare Practitioners and Technical OccupationHealthcare Support Occupations:Nursing, Psychiatric, or Home Health AideOccupational and Physical Therapist Assistant or AideOther Healthcare Support OccupationBusiness, Executive, Management, and Financial Occupations:Chief ExecutiveGeneral and Operations ManagerAdvertising, Marketing, Promotions, Public Relations, and Sales ManagerOperations Specialties Manager (e.g., IT or HR Manager)Construction ManagerEngineering ManagerAccountant, AuditorBusiness Operations or Financial SpecialistBusiness OwnerOther Business, Executive, Management, Financial OccupationArchitecture and Engineering Occupations:Architect, Surveyor, or CartographerEngineerOther Architecture and Engineering OccupationEducation, Training, and Library Occupations:Postsecondary Teacher (e.g., College Professor)Primary, Secondary, or Special Education School TeacherOther Teacher or InstructorOther Education, Training, and Library OccupationOther Professional Occupations:Arts, Design, Entertainment, Sports, and Media OccupationsComputer Specialist, Mathematical ScienceCounselor, Social Worker, or Other Community and Social Service SpecialistLawyer, JudgeLife Scientist (e.g., Animal, Food, Soil, or Biological Scientist, Zoologist)Physical Scientist (e.g., Astronomer, Physicist, Chemist, Hydrologist)Religious Worker (e.g., Clergy, Director of Religious Activities or Education)Social Scientist and Related WorkerOther Professional OccupationOffice and Administrative Support Occupations:Supervisor of Administrative Support WorkersFinancial ClerkSecretary or Administrative AssistantMaterial Recording, Scheduling, and Dispatching WorkerOther Office and Administrative Support OccupationServices Occupations:Protective Service (e.g., Fire Fighting, Police Officer, Correctional Officer)Chef or Head CookCook or Food Preparation WorkerFood and Beverage Serving Worker (e.g., Bartender, Waiter, Waitress)Building and Grounds Cleaning and MaintenancePersonal Care and Service (e.g., Hairdresser, Flight Attendant, Concierge)Sales Supervisor, Retail SalesRetail Sales WorkerInsurance Sales AgentSales RepresentativeReal Estate Sales AgentOther Services OccupationAgriculture, Maintenance, Repair, and Skilled Crafts Occupations:Construction and Extraction (e.g., Construction Laborer, Electrician)Farming, Fishing, and ForestryInstallation, Maintenance, and RepairProduction OccupationsOther Agriculture, Maintenance, Repair, and Skilled Crafts OccupationTransportation Occupations:Aircraft Pilot or Flight EngineerMotor Vehicle Operator (e.g., Ambulance, Bus, Taxi, or Truck Driver)Other Transportation OccupationOther Occupations:MilitaryHomemakerOther OccupationDon't KnowNot ApplicableAre you an athlete?YesNoHow many hours a day do you work? *Less than 8 hours8 hours9 hoursMore than 10 hoursDo you work the night shift? *YesNoRotational Night ShiftHow many hours a day do you spend in the sitting (chair) position? *Less than 3 hours a day3-5 hours a day6-8 hours a dayMore than 8 hours a dayDo you work for more than 3 hours without a break? *AlwaysSometimesOccasionally/RarelyNeverIf yes, how often? *1 Day/Week2 Days/Week3 Days/Week4 Days/Week5 Days/Week6 Days/Week7 Days/WeekOn an average, how many hours a day do you spend in front of the computer? *Less than 3 hours a day3-5 hours a day6-8 hours a dayMore than 8 hours a dayHow do you commute to work? Choose multiple if applicable. *I drive to workI carpoolI ride a bikeI take a cabI take the BusI take the TrainI walk to workI work from homeIs your travel to work long? *YesNoHow long is your commute? *20 - 30 minutes1 hourHow is your journey to work? *TiringUncomfortableFatiguedNone of the aboveGo BackNextCurrent Lifestyle Information - HabitsDo you smoke? *YesYes, sociallyNoNo, but I used to in the pastHow often do you smoke in a day? *Once a day2-5 times a day5-10 times a dayMore than 10 times a dayHow long have you been a smoker? *Less than a year1-3 years3-5 yearsMore than 5 yearsHow long has it been since you quit? *Less than 1 year1-3 yearsMore than 3 yearsDo you consume alcohol? *YesNoNo, but I used to in the pastHow often do you consume alcohol? *EverydayTwice or thrice a weekOnce a weekOnce every two weeksOnce a monthOnly during social gatherings (once in a few months)What are you preferred alcoholic drinks (ones most often consumed)? *BeerWineHard CiderMeadSakéGinBrandyWhiskeyRumTequilaVodkaAbsintheEverclearHow many drinks do you have on an average? *1 drink2-3 drinksMore than 4 drinksHow long has it been since you quit alcohol? *Less than 1 year1-3 yearsMore than 3 yearsDo you drink caffeinated beverages? *YesNoIf yes, please choose your choice of beverage *CoffeeTeaEnergy drinks (Red Bull, Monster, Mountain Dew, etc.,)How often do you consume caffeinated drinks? *Once a dayTwice a dayThrice a dayMore than thrice a dayWhat are the hours when you consume caffeinated drinks? *9 am to 12 pm12 pm to 3pm3 pm to 6 pm6 pm to 9 pmIs there any particular reason for this consumption? *RecreationLike the tasteEnergy supplementHabitualHave you faced any of the following withdrawal symptoms when avoiding caffeine intake for more than 3 days *HeadachesSleepinessIrritabilityLethargyConstipationDepressionMuscle Pain, Stiffness, CrampingLack of ConcentrationFlu-like symptomsInsomniaNausea and VomitingAnxietyBrain FogDizzinessHeart Rhythm AbnormalitiesNone of the aboveDo you consume any form of drugs for recreational purposes? *YesNoNo, but I used to in the pastFor how many years have you consumed it? *Less than 1 year1-3 yearsMore than 3 yearsDo you partake in any of the below mentioned habits? *PaanTobaccoBeediOthersNone of the abovePlease mention themGo BackNextCurrent Lifestyle Information - SleepDo you have trouble falling asleep at night? *AlwaysSometimesNeverDo you take any medication(s) before bed? *YesNoPlease list the medications you take before bed. *On average, how many hours do you sleep at night? *Less than 4 hours5 hours6 hours7 hours8 hours9 hoursMore than 9 hoursAt what time do you usually sleep? *8 pm9 pm10 pm11pm12 am1 amPast 1 amIn the mornings (due to night shift)What prevents you from falling asleep/having a sound sleep? *I cannot fall asleep when there is any light source aroundI work late into the nightI usually over think in bedI use gadgets late into the night(Laptop, Phone, etc.,)OtherPlease list any other reasons *Go backNextCurrent Lifestyle Information - ExerciseHow regularly do you exercise? *AlwaysSometimesNeverWhat are some of the physical activities you do? *WalkingJoggingRunningPlaying sportsGoing to the Gym/ Trained workoutsYogaSkippingSwimmingMartial arts/Combat sportsFunctional TrainingNone of the aboveHow many minutes in a day do you engage in your preferred physical activities? *Less than 10 minutes30 minutes60 minutes90 minutesMore than 90 minutesHow many days in a week do you engage in your preferred physical activities? *Only on the weekendsOnly on the weekdays1 day2 days3 days4 days5 days6 days7 daysWere you trained by professionals in regard to these physical activities? *YesNoDo you exercise to the point of fatigue/exhaustion? *AlwaysSometimesNeverDo you experience any of the following symptoms post your physical fitness regime? *Sharp shooting painsSwellingNauseaDizzinessOthersNone of the aboveGo BackNextCurrent Lifestyle Information - NutritionAre you allergic to any of the following food items? (Confirmed or Suspected by you) *BrinjalCeleryCocoaEggFishGarlicGlutenMangoMeatMilkPeanutRiceSesameShellfishShrimpSoyStrawberriesTomatoesWheatNone of the aboveWhich of the following food lifestyles do you follow? *Non vegetarianOvo-vegetarianPescetarianVeganVegetarianDo you follow any of the following dietary patterns? *Gluten FreeLactose FreeWheat FreePaleo DietKetogenic DietNone of the aboveWould you like Intermittent Fasting(IF) to be enrolled in your diet? *YesNoNeed to consultHow many times a day do you have/try to have a balanced meal? *OnceTwiceThriceOn average, how many litres of water do you consume daily? *Less than 2 litres2-4 litresMore than 4 litresDo you consume junk food? *YesNoIf yes, please choose which *Fast foodsPackaged foodsCanned foodsDo you usually eat until you are uncomfortably full? *AlwaysSometimesNeverDo you feel hungry within 3 hours of having eaten a meal? *AlwaysSometimesNeverDo you consciously avoid the consumption of any food products for personal reasons? *YesNoIf yes, what? *Do you face discomfort when consuming certain food items? *YesNoIf yes, what? *Do you face bowel problems when you consume any food items? *YesNoIf yes, what? *Are you currently taking whey protein supplement? *YesNoAre you willing to take whey protein supplement? *YesNoHow would you describe your bowel movements? *NormalConstipatedDiarrhoeaAlternating between constipation and DiarrhoeaDo you experience pain before/during/after your bowel movements? *YesNoIf yes, when? *BeforeDuringAfterHow often do you resort to de-worming? *NeverOnce in 6 monthsOnce in a yearNot unless the doctor advises itHow often do you urinate throughout the day? *2-3 times4-6 times7-10 timesMore than 10 timesWhat is the colour of the urine usually? *Transparent yellow/Pale yellowDark yellowBrownishPink to RedOrangeBlue or GreenHow often does this coloration occur? *EverydayOnly when I eat certain foodsVery rarelyIs it still persisting? *YesNoHave you consulted a doctor about it? *YesNoWhat was the prognosis?Go BackNextRelationshipAre you currently under any contraceptives? *YesNoWas it prescribed by your Doctor to treat a condition such as PCOD? *YesNoAre your menstrual cycles regular? *YesNoAre there any issues faced during the cycle? *Menstrual CrampsAcneBloatingBackachesPain in breastsLoss of appetiteFood cravingsConstipationDiarrhoeaExtreme mood swingsNone of the aboveDo the cramps last for more than 2 days? *YesNoHave you had irregular bleeding? (outside the menstrual cycle) *YesNoAre you sexually active? *YesNoFor how long have you been sexually active? *0-2 years2-5 yearsMore than 5 yearsAre you pregnant? *YesNoWhen is your due date?How many weeks into your pregnancy are you?Have you been pregnant before? *YesNoHave you had a miscarriage/abortion? *YesNoDo you have a child/children? *YesNoWas it a C-section or a Normal delivery? *C-SectionNormalDid you have any complications during the pregnancy? *YesNoAre you currently Breastfeeding? *YesNoHave you had a preterm baby? *YesNoAre you experiencing any of the following? *ProstatitisLow testosteroneInfertilityPain while urinatingRashes on or around your sexual organsBaldnessHair fall in patchesTrouble with sexual functionsNone of the aboveGo BackNextCompliance SectionHow likely are you to follow the diet that will be prescribed to you?12345678910How likely are you to follow the overall suggestions prescribed to you?12345678910Go BackNextYour typical meal consumptionPlease list down what you would typically consume on a normal day.Breakfast *Mid Day Snack *Lunch *Evening Snack *Dinner *Go BackNextMeal PreferencesChoose the type of meals you would like for Breakfast (choose 3 options) *SmoothieSandwichesPastaEgg dishPancakesBreakfast jarSaladsTiffinChoose the type of meals you would like for Lunch (choose 3 options) *SmoothieSandwichesPastaEgg dishCurrySoups & StewsGrillRiceVegetablesSaladsOne pot mealNoodlesChoose the type of meals you would like for Dinner (choose 3 options) *SmoothieSandwichesPastaEgg dishCurrySoups & StewsGrillRiceVegetablesSaladsOne pot mealTiffinNoodlesHow would you prefer your meal composition to be? *High CarbohydrateHigh FatHow would you like to approach your meal plan? *Weigh your food (using a food scale)Portion controlWould you like snack options along with your protocol? *YesNoPhoneSubmit[/vc_column][/vc_row]