Order Form | Nutrition and Diet Services

If you would prefer not to use a web form, you may download a fillable pdf copy of the form (Nutrition Facts Label, Diet Analysis, or Restaurant/Cookbook Analysis) and return it to us by email or fax.

Name*

First Last

Company Name

Are you a first time customer?*

Yes, this is my first order with NDS
No
No, but my contact information has changed

Service Requested*

Nutrition Facts Panel
Restaurant and Cookbook Analysis
Diet Analysis

Additional Nutrition Facts Panel Services

Review my current Nutrition Facts Panel
Review my health claims

Are you an institution or a dietitian/researcher/individual?

Institution
Dietitian, Researcher, or Individual

Contact Information

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Email

Phone

Fax

Nutrition Facts Panel Information

Nutrition Facts Panel Product

Product Name*

Label Format

Nutritional Facts Panel
Dual Nutritional Facts Panel
Nutrient Analysis Only (no label)

Submission Type

New Product
Similar Product

Check "Similar Product" if you have made only 1 or 2 minor changes from a product previously analyzed by NDS. Discount subject to approval by NDS staff.

Discount

Price: $0.00

Product Category*

What kind of food is the product?

Specify Other

Product Form (as sold)*

Specify Other

Is a serving of your product measured in pieces or cups?

Pieces
Cups

Raw Ingredients

In this section, please give weights before processing.

Ingredient Worksheet

Ingredient Name and Description	Brand Name and/or Product code #	Supplier phone no.	Amount	Weight Unit

Add additional rows by clicking on the plus sign.

Total batch weight before processing

Weigh a whole batch of your product before you start processing.

Unit

Raw piece weight

Weigh a single piece before processing.

Unit

Number of pieces per batch

After processing

In this section, we are asking for weights after all of the processing and just before packaging.

Total batch weight after processing

Unit

Number of cups per batch (after processing)

Weight of one finished piece

Unit

Weight of one cup

Unit

Package net weight

Weigh contents only (not package).

Unit

Your Package

What are the dimensions of your package?

Write "unknown," if you don't yet have a package. Write in the size of multiple packages, separated by semicolons, if you are using more than one size.

Is it a non-US label?

Yes
No

What country or region is it for?

Please specify Canada, EU, or Australia.

Ingredient Declaration

Basic Ingredient Statement
Full Disclosure

The FDA requires that all ingredients AND sub-ingredients be listed in descending order by weight. With the Full Disclosure option NDS will list your sub-ingredients by weight, if you select the Basic Ingredient Statement option, it will be your responsibility to insert that information in the ingredient list.

Basic: Statement Chocolate (list sub-ingredients), Cacao Nibs.

Full Disclosure: Dark Chocolate (unsweetened chocolate, sugar, cocoa butter, soy lecithin [emulsifier], natural vanilla extract), Cacao Nibs.

NDS staff will contact you for additional information regarding your products.

Allergen Statement

NDS adds allergen statement
I will do the allergen statement

The FDA requires that 8 specific food allergens be identified. This can be within the ingredient statement or following the ingredient statement.

Menu or Diet Analysis

For Institutions

Diet or menu analysis product

Number of Meals and Snacks per Day

3 meals and 2 snacks
2 meals and 2 snacks
1 meal

Number of weeks of analysis

Number of days/week

Diet Variations

Regular
Low Sodium
Diabetic
Low Cholesterol/Low Fat
Renal
Other

Describe Food Type and Give Your Standard Portion Size

Milk

Whole
2%
1%
Skim

Standard Portion Size

Unit

Juices

Standard Portion Size

Unit

Fruits

Standard Portion Size

Unit

Entree

Meal	Portion size

Vegetables

Fresh
Frozen
Canned
Salted
Unsalted

Standard Portion Size

Unit

Dressing

Regular
Reduced Fat
Nonfat
Other

Standard Portion Size

Unit

Fats

Butter
Stick margarine
Soft margarine
Oil

Standard Portion Size

Unit

Breads

White
Wheat
Roll (in ounces)
Other

Standard Portion Size

Unit

Additional information

Describe any other information we need to know about your menu.

Dietary standards to apply:

RDA Standard
DRI Standard

Age Range

Gender

Male
Female

Food Record Analysis

For dietitians, researchers and individuals

Food Record Analysis

Price: $125.00

For one day

Each Additional Day

Price: $100.00 Quantity:

Food Records

Drop files here or

You may either upload your food records here or email them to NDS.

Dietary standards to apply:

RDA Standard
DRI Standard

Age Range

Gender

Male
Female

Additional information

Describe any other information we need to know about your food records.

Restaurant and Cookbook Analysis

Recipe or Menu Item Analysis

Price: $85.00 Quantity:

Price is per recipe or menu item.

Upload your recipes

Drop files here or

You may either upload files here or email them to NDS.

Check Nutrients Desired (pre-checked required for restaurants)

Specify Other:

Select One

Analyze each item separately
Analyze the entire plate

Identification of Special Diet Menu Items

Gluten-Free
Vegetarian
Vegan

Charged at the hourly rate. Please provide complete ingredient statements for all ingredients so we can make these identifications.

Verify Health Claims or Review Current Label

Upload your current label for review.

Upload your current label

Drop files here or

Hourly Consulting Fee (price is per hour, but it is billed in 5 minute increments)

Price: $240.00 Quantity:

NDS will get back to you with an estimate of the amount of time that will be required to review your label or verify your health claims.

Do you have any additional questions or comments?

Rush Options

When should we return your completed order?

7 to 10 business days
2-3 day expedited
24 hours

Times counted from when NDS receives all of your information and has all of our questions answered. Changes to analysis already done will be charged as a second analysis. Sub-recipe analysis is charged as any other item analysis.

Rush pricing

Price: $0.00

Rush pricing

Price: $0.00

Estimated Total Order

Price subject to review and revision by NDS staff.

Total

$0.00

Email

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