HyungInJae’s Secret Diet online survey HyungInJae’s Secret Diet Program is a 1:1 personalized Diet program.online questionnaire for a face-to-face prescription. The same content as in-person surveys used in clinics,You can check all questions multiple times.If you don’t see a description that fits your conditionplease feel free to write in the ‘other’ box for each question. Please fill in the form without any blanks! 11. basic information22. digestion-defecation-sleep33. edema – menstrual – pain – fatigue44. medical history – medications – exercise55. weight – Diet experience66. Goals – Diet77. meals-snacks-drinks-drinks-drinks-coffee NameThis field is for validation purposes and should be left unchanged.Please tell us your name.(Required)Please provide your cell phone number (e.g. 01012345678)(Required)Please provide your email address. Please tell us your gender.(Required) Female Male Other Please tell us your age.(Required)Please provide your height/weight/body fat percentage (if you don't know your exact body fat percentage, please provide your height and weight only). (Required)Please tell us if you plan to get pregnant (birth control is mandatory during the Diet). I’m planning a pregnancy I’m not planning to get pregnant Other How did you hear about HyungInJae Korean Medicine Clinic?(Required) Naver Search Online Community Social Media (Instagram, Threads, TikTok, YouTube, etc.) Referral from a Friend or Family Member Other Tell us how your digestion is going.(Required) I have a good digestive system Bloating when overeating Bloating without overeating Heartburn before meals Heartburn after eating Occasional eating Eat frequently Sour grapes No digestive issues Tell us if you have any food intolerances (write 'none' if you don't) Tell me about your usual bowel/bladder movements.(Required) Defecation Tendency to constipation Diarrhea tendencies Depends on the food How many times do you poop every few days (e.g., every 2 days)? (Required)How many times a day do you urinate?(Required)Please tell us if you have any symptoms of discomfort when urinating (write 'none' if none) Tell us how you usually sleep.(Required) Get a good night’s sleep Difficulty falling asleep Easily falling asleep Difficulty waking up Affected by coffee Do you have a regular sleep schedule?(Required) Regular Irregular Shifts What time do you typically go to bed and what time do you wake up (e.g., go to bed between 22-24am, wake up at 7am)? (Required) Do you usually experience swelling, and if so, where? (Required) None Facial Upper Limb (Hand) Lower limbs (calves, feet) What time of day do you typically experience edema?(Required) AM afternoon Night All day Please tell us the cause of your edema (if you don't know, write 'don't know') Tell me about your usual menstrual cycle.(Required) Constant Slightly irregular Highly irregular Amenorrhea Menopause Please tell us when your last period started (write 'none' for amenorrhea/menopause) (Required)Tell me about your typical menstrual symptoms.(Required) Some discomfort due to period pain Period pain hurts but you put up with it Needing painkillers for period pain Increased appetite Swelling occurs No menstrual issues Please tell us if you usually have pain. If so, please describe the area of pain in the 'Other' field. (Required) I have pain No pain If you usually feel tired/lethargic, please tell us when you do.(Required) Upon waking AM afternoon Night Almost always For medical history, please check all boxes that apply, past or present.(Required) Liver disease (carrier/fatty liver/hepatic function) Heart disease Kidney disease Thyroid disease Uterine Ovarian Disease Diabetes High blood pressure Hyperlipidemia None Please tell us if you have any relevant surgical experience (if not, write 'none') Please tell us if you are currently taking any medications/supplements (if not, write 'none') Tell us about your exercise habits.(Required) I like to exercise You don’t like to exercise I rarely exercise I exercise occasionally I exercise frequently I exercise regularly Tell us about any exercise patterns you've been keeping up lately (e.g., 30-minute walks three times a week). Tell us about your average weight over the last 10 years (e.g., approximately 70 kg) (Required)Tell us about your average weight in the past year (e.g., approximately 70 kg) (Required)Tell me about any major weight changes in the past (e.g., at age 25, I (slowly/rapidly) (gained/lost) 10 pounds in 5 months due to (cause)) (write 'none' if none) Please tell me about any recent weight changes (e.g., at age 28, I (slowly/rapidly) (gained/lost) about 10 pounds in 5 months due to (cause)) (write 'none' if none) Tell us about your most successful diet experience (e.g., I lost 10 kg in 5 months on a (Chinese/Western/Self) Diet when I was 25) (if none, write 'none') Tell us about your most recent diet experience (e.g., I lost 10 kg in 5 months on a (Chinese/Western/Self) Diet when I was 28) (if none, write 'none') Tell us about your experience with Diet pills (please include the type and length of time you took them, when you took them, the effects you noticed, and any side effects) (if none, write 'none')Tell us about your biggest struggles, side effects, yo-yo experiences, etc. with the Diet (write 'none' if none) Please tell us the length of your Diet, your goals, and your final desired weight (e.g., I want to lose 10 kg in 3 months, final goal 55 kg) (Required)Tell us where you'd like to reduce the size. Faces Arm Shoulder/Back Abdomen/Sideburns Thigh/Calf Tell me your goals for the Diet.(Required) Lose weight Reduce size Prevent yo-yoing Improving health Improve your constitution Tell us about your dietary habits.(Required) Have a regular eating schedule I eat at irregular times I eat smaller meals Meal portions are moderate You eat a lot I eat irregularly Slow to eat I’m a moderate eater Eat fast How stress affects your diet Stress doesn’t affect my diet Tell me about the eating patterns that are problematic for your Diet.(Required) Meals Snacks Midnight snacks Drinking No problematic expressions Please tell us the average number, time, and portion size of your meals (e.g., 2 meals per day/12:00, 19:00/average of 1 and a half) (Required)Please tell us your breakfast time and average menu (e.g., 7am, sandwich) (if none, write 'none') Please tell us your lunch time and average menu (e.g. 13:00, varies daily) (if none, write 'none') Please tell us your dinner time and average menu (e.g. 19:00, home-cooked) (if none, write 'none') Tell us about your snacking habits.(Required) Rarely eaten How much to eat if any Eat often Eat several times a day Replacing meals with snacks How many snacks do you eat on average per week?Tell us your favorite type of snack/night snack.Tell us about your drinking habits.(Required) Not drinking How much to drink if any Drink often Meal accompaniments Midnight snack accompaniment Tell me how many drinks you have on average per week.(Required)Tell us what you enjoy drinking most often and how much you drink on average (e.g., 2 cans of beer). Tell us how much and how often you usually drink water (e.g., 2 liters per day, often) (Required)Please tell us how many cups of coffee you drink per day (e.g., 2 light in the morning and 1 strong in the afternoon). (Required)Tell me about your symptoms when you drink coffee.(Required) No impact Heart palpitations Sleep disturbance Are there any special needs or issues you have that we should be aware of? If so, please feel free to share them with us. I agree to the collection and use of personal information(Required) I agree to the collection and use of personal informationHyunginjae Korean Medicine Beauty Clinic (hereinafter referred to as the ‘Company’), in accordance with Article 30 of the Personal Information Protection Act, establishes and discloses the following personal information processing guidelines in order to protect the personal information of the information subject and to promptly and smoothly handle any grievances related thereto. Article 1 (Purpose of Processing Personal Information) Company processes personal information for the following purposes. The personal information processed will not be used for any purpose other than the following purposes, and if the purpose of use changes, the Company will take necessary measures such as obtaining separate consent in accordance with Article 18 of the Personal Information Protection Act. 1. Homepage membership registration and management Personal information is processed for the purpose of confirming the intention to join the membership, identifying and authenticating the person in accordance with the provision of membership services, maintaining and maintaining membership, identifying the person in accordance with the implementation of a limited identification system, preventing unauthorized use of the service, confirming the consent of the legal representative when processing personal information of children under the age of 14, various notices and notifications, and handling grievances. 2. Provision of goods or services We process personal information for the purpose of delivering goods, providing services, sending contracts and invoices, providing content, providing customized services, identification, age verification, payment and settlement of fees, and debt collection. 3. Grievance handling processes personal information for the purpose of identifying the identity of the complainant, verifying the complaint, contacting and notifying the complainant for fact-finding, and notifying the result of the processing. Article 2 (Processing and Retention Period of Personal Information) ① The Company shall process and retain personal information within the period of retention and use of personal information in accordance with the laws and regulations or within the period of retention and use of personal information agreed upon when collecting personal information from the information subject. ② The period of processing and retention of each personal information is as follows. 1. Website membership registration and management: Until withdrawal from the business/organization website However, if the following reasons apply, until the end of the reason 1) If an investigation or investigation is underway due to violation of relevant laws and regulations, until the end of the investigation or investigation 2) If a debt or debt relationship remains due to the use of the website, until the settlement of the debt or debt relationship 2. Provision of goods or services: Until the completion of the supply of goods and services and the completion of payment and settlement However, in the following cases, until the end of the period 1) Records on transactions such as display, advertisement, contract contents and performance in accordance with the 「Act on Consumer Protection in Electronic Commerce, etc.」 – Records on display and advertisement : 6 months – Records of contract or subscription withdrawal, payment, supply of goods, etc.: 5 years – Records of consumer complaints or dispute handling: 3 years 2) Retention of telecommunication fact verification data pursuant to Article 41 of the 「Protection of Communications Secrets Act」 – Subscriber telecommunication date, start and end time, other subscriber number, usage, and location tracking data of the sending base station: 1 year – Computer communication, internet log records, and access point tracking data: 3 months Article 3 (Provision of Personal Information to Third Parties) ① The Company processes the personal information of the information subject only within the scope specified in Article 1 (Purpose of Processing Personal Information) and provides personal information to third parties only in cases falling under Article 17 of the Personal Information Protection Act, such as the consent of the information subject or special provisions of the law. ② The Company provides personal information to third parties as follows: – Persons to whom personal information is provided: <예) (주) OOO 카드> – The purpose for which the recipient uses the personal information : <예) 이벤트 공동개최 등 업무제휴 및 제휴 신용카드 발급> – What personal information you provide : <예) 성명, 주소, 전화번호, 이메일주소, 카드결제계좌정보> – Recipient’s retention and use period : <예) 신용카드 발급계약에 따른 거래기간동안> Article 4 (Consignment of Personal Information Processing) ① The Company consigns personal information processing as follows to ensure smooth personal information processing. – Consignee (Trustee): Iweb – Contents of consigned business: system provision of shopping mall hosting service, mobile app service, marketing services and add-ons, affiliate service provision and notification talk, friend talk, text message delivery agency service, etc. – The entrustee (trustee): OOO PG – the content of the work entrusted: payment and escrow operations – The recipient (trustee): OOO Courier – the content of the work entrusted: delivery of goods – The entrusted person (trustee): OOO Customer Center – The content of the entrusted services: customer consultation services – The entrusted person (trustee): OOO – The content of the entrusted services: identity verification services ② When entering into a consignment contract, the Company specifies in documents such as contracts the prohibition of processing personal information other than for the purpose of performing consignment work, technical and administrative protection measures, restrictions on re-consignment, management and supervision of the consignee, and liability for damages in accordance with Article 25 of the Personal Information Protection Act, and supervises whether the consignee handles personal information safely. ③ If the contents of the consignment work or the trustee change, we will disclose it through this privacy policy without delay. Article 5 (Rights of Users and Their Legal Representatives and How to Exercise Them) ① The information subject may exercise the following personal information protection rights against the Company at any time. 1.Request to view personal information 2. Request for correction of errors 3. Request for deletion 4. Request for suspension of processing ② The exercise of rights under Paragraph 1 may be made in writing, by telephone, e-mail, facsimile transmission (FAX), etc. to the Company, and the Company will take action without delay. ③ If the information subject requests the correction or deletion of errors in personal information, the Company shall not use or provide the personal information until the correction or deletion is completed. ④ The exercise of the rights under Paragraph 1 may be made through an agent, such as the legal representative of the information subject or a person who has been delegated. In this case, a power of attorney in the form of Appendix No. 11 to the Enforcement Rules of the Personal Information Protection Act must be submitted. ⑤ The information subject shall not infringe on the personal information and privacy of the information subject or others processed by the Company in violation of relevant laws and regulations such as the Personal Information Protection Act. Article 6 (Items of Personal Information Processed) The Company processes the following items of personal information. 1. Sign up and manage your homepage membership at Required: <예) 성명, 생년월일, 아이디, 비밀번호, 주소, 전화번호, 성별, 이메일주소, 아이핀번호> Optional: <예) 결혼 여부, 관심 분야> 2. provide goods or services Required: <예) 성명, 생년월일, 아이디, 비밀번호, 주소, 전화번호, 이메일주소, 아이핀번호, 신용카드번호, 은행계좌정보 등 결제정보> Optional: <관심분야, 과거 구매내역> 3. The following personal information items may be automatically generated and collected in the course of using the Internet service. IP address, cookies, MAC address, service usage history, visit history, bad usage history, etc. Article 7 (Destruction of Personal Information) ① The Company shall destroy the personal information without delay when the personal information becomes unnecessary, such as the expiration of the personal information retention period or the achievement of the purpose of processing. ② When the personal information retention period agreed to by the information subject has expired or the purpose of processing has been achieved, but the personal information must continue to be preserved in accordance with other laws and regulations, the personal information shall be transferred to a separate database (DB) or preserved in a different storage location. ③ The procedures and methods for destroying personal information are as follows. 1.Destruction Procedure The Company selects the personal information for which the reason for destruction has occurred and destroys the personal information with the approval of the Company’s personal information protection officer. 2. Destruction Method The Company destroys personal information recorded and stored in the form of electronic files using methods such as Low Level Format so that the records cannot be reproduced, and destroys personal information recorded and stored in paper documents by shredding or incineration. Article 8 (Measures to ensure the safety of personal information) The Company takes the following measures to ensure the safety of personal information. 1. Administrative measures: establishment and implementation of internal management plans, regular employee training, etc. 2. Technical measures: management of access rights to personal information processing systems, installation of access control systems, encryption of unique identification information , installation of security programs 3. Physical measures: access control to computer rooms, data storage rooms, etc. Article 9 (Installation, Operation and Refusal of Automatic Collection of Personal Information) ① The Company uses ‘cookies’ to store and retrieve usage information from time to time to provide users with individually customized services. ② Cookies are small amounts of information sent to the user’s computer browser by the server (http) used to operate the website and may be stored on the hard disk of the user’s computer. Purpose of use of cookies: Cookies are used to provide optimized information to users by identifying the type of visit and use of each service and website visited by users, popular search terms, secure connection, etc. I. Installation, operation and rejection of cookies: You can reject the storage of cookies by setting the options in the Tools>Internet Options>Privacy menu at the top of your web browser. D. If you refuse to save cookies, you may have difficulty using our personalized services. Article 10 (Personal Information Protection Officer) ① The Company is responsible for the processing of personal information in general, and designates a personal information protection officer as follows to handle complaints and remedy damages of information subjects related to the processing of personal information. ▶ Privacy Officer Name : OOO Position : OOO Contact : <전화번호>, <이메일>, <팩스번호> You will be directed to the Privacy Office. ▶ Privacy Department Department Name : OOO Team Person in charge : OOO Contact : <전화번호>, <이메일>, <팩스번호> ② The information subject may inquire about all personal information protection-related inquiries, complaints, damage relief, etc. arising from the use of the Company’s services (or business) to the person in charge of personal information protection and the department in charge. The Company will respond to and handle inquiries from the information subject without delay. Article 11 (Request for access to personal information) The information subject may request access to personal information pursuant to Article 35 of the Personal Information Protection Act to the following departments. The Company will endeavor to promptly process your request for access to your personal information. ▶ Personal Information Access Request Reception and Processing Department Department Name : OOO Person in charge : OOO Contact : <전화번호>, <이메일>, <팩스번호> Article 12 (Remedies for infringement of rights and interests) The information subject may contact the following organizations for damage relief, consultation, etc. regarding infringement of personal information. ▶ Personal Information Infringement Report Center (operated by the Korea Internet & Security Agency) – Responsibilities: Report personal information infringement, request consultation – Homepage: privacy.kisa.or.kr – Phone: (without area code) 118 – Address: (58324) 9, Jinheung-gil, Naju-si, Jeollanam-do (301-2, Light Garam-dong), Korea ▶ Personal Information Dispute Mediation Committee – Jurisdiction: Personal information dispute mediation application, collective dispute mediation (civil resolution) – Homepage: www.kopico.go.kr – Telephone: (without area code) 1833-6972 – Address: (03171) Government of Korea Seoul Office 4F, 209 Sejong-daero, Jongno-gu, Seoul, Korea Supreme Prosecutors’ Office Cybercrime Investigation Division: 02-3480-3573 (www.spo.go.kr) ▶ National Police Agency Cyber Safety Bureau: 182 (http://cyberbureau.police.go.kr) Article 13 (Implementation and Changes to the Privacy Policy) This Privacy Policy is effective as of 20XX. X. Effective with X.
