{"id":12280,"date":"2022-09-26T20:56:06","date_gmt":"2022-09-26T19:56:06","guid":{"rendered":"https:\/\/verloskundigenpraktijkdehof.nl\/site21\/?page_id=12280"},"modified":"2022-09-26T21:27:33","modified_gmt":"2022-09-26T20:27:33","slug":"aanmeldformulier-plaatsen-spiraaltje","status":"publish","type":"page","link":"https:\/\/verloskundigenpraktijkdehof.nl\/site21\/aanmeldformulier-plaatsen-spiraaltje\/","title":{"rendered":"Aanmeldformulier Plaatsen Spiraaltje"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"12280\" class=\"elementor elementor-12280\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-3800c8ef elementor-section-stretched elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"3800c8ef\" data-element_type=\"section\" data-e-type=\"section\" data-settings=\"{&quot;stretch_section&quot;:&quot;section-stretched&quot;,&quot;background_background&quot;:&quot;classic&quot;,&quot;shape_divider_bottom&quot;:&quot;opacity-tilt&quot;}\">\n\t\t\t\t\t\t\t<div class=\"elementor-background-overlay\"><\/div>\n\t\t\t\t\t\t<div class=\"elementor-shape elementor-shape-bottom\" aria-hidden=\"true\" data-negative=\"false\">\n\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" viewBox=\"0 0 2600 131.1\" preserveAspectRatio=\"none\">\n\t<path class=\"elementor-shape-fill\" d=\"M0 0L2600 0 2600 69.1 0 0z\"\/>\n\t<path class=\"elementor-shape-fill\" style=\"opacity:0.5\" d=\"M0 0L2600 0 2600 69.1 0 69.1z\"\/>\n\t<path class=\"elementor-shape-fill\" style=\"opacity:0.25\" d=\"M2600 0L0 0 0 130.1 2600 69.1z\"\/>\n<\/svg>\t\t<\/div>\n\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-27f5369f\" data-id=\"27f5369f\" 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-2c58d2f9 elementor-widget elementor-widget-heading\" data-id=\"2c58d2f9\" 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<h2 class=\"elementor-heading-title elementor-size-default\">Spiraaltje Plaatsen<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-1b6713ed elementor-widget elementor-widget-spacer\" data-id=\"1b6713ed\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-4d337d2a elementor-widget elementor-widget-heading\" data-id=\"4d337d2a\" 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<h2 class=\"elementor-heading-title elementor-size-default\"><span class=\"elementor-heading-title elementor-size-default\" style=\"line-height: 1.1\">MELD JE AAN VIA HET ONLINE AANMELDFORMULIER<\/span><\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-26a61220 elementor-widget elementor-widget-spacer\" data-id=\"26a61220\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\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<section class=\"elementor-section elementor-top-section elementor-element elementor-element-c7a52c8 elementor-section-full_width elementor-section-stretched elementor-section-height-default elementor-section-height-default\" data-id=\"c7a52c8\" data-element_type=\"section\" data-e-type=\"section\" data-settings=\"{&quot;stretch_section&quot;:&quot;section-stretched&quot;,&quot;background_background&quot;:&quot;classic&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-6278852\" data-id=\"6278852\" 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-e4c710a elementor-widget__width-inherit elementor-widget elementor-widget-text-editor\" data-id=\"e4c710a\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><p><\/p>\n<div id=\"vfb-form-2\" class=\"visual-form-builder-container\">\n<form id=\"aanmeldformulier-plaatsen-spiraal-2\" class=\"visual-form-builder vfb-form-2 \" method=\"post\" enctype=\"multipart\/form-data\">\n\t  \t<input type=\"hidden\" name=\"form_id\" value=\"2\" \/><\/p>\n<fieldset class=\"vfb-fieldset vfb-fieldset-1 aanmeldformulier-plaatsen-spiraal \" id=\"item-vfb-46\">\n<div class=\"vfb-legend\">\n<h3>Aanmeldformulier plaatsen spiraal<\/h3>\n<\/div>\n<ul class=\"vfb-section vfb-section-1\">\n<li class=\"vfb-item vfb-item-text  \" id=\"item-vfb-51\"><label for=\"vfb-51\" class=\"vfb-desc\">Voornaam <\/label><input type=\"text\" name=\"vfb-51\" id=\"vfb-51\" value=\"\" class=\"vfb-text  vfb-medium   \" \/><\/li>\n<li class=\"vfb-item vfb-item-text  \" id=\"item-vfb-52\"><label for=\"vfb-52\" class=\"vfb-desc\">Achternaam (meisjesnaam)  <span class=\"vfb-required-asterisk\">*<\/span><\/label><input type=\"text\" name=\"vfb-52\" id=\"vfb-52\" value=\"\" class=\"vfb-text  vfb-medium  required  \" \/><\/li>\n<li class=\"vfb-item vfb-item-date  \" id=\"item-vfb-54\"><label for=\"vfb-54\" class=\"vfb-desc\">Geboortedatum  <span class=\"vfb-required-asterisk\">*<\/span><\/label><input type=\"text\" name=\"vfb-54\" id=\"vfb-54\" value=\"01\/01\/1990\" class=\"vfb-text vfb-date-picker  vfb-medium  required \" data-dp-dateFormat=\"dd\/mm\/yyyy\" \/><\/li>\n<li class=\"vfb-item vfb-item-number  \" id=\"item-vfb-55\"><label for=\"vfb-55\" class=\"vfb-desc\">BSN-nummer  <span class=\"vfb-required-asterisk\">*<\/span><\/label><input type=\"text\" name=\"vfb-55\" id=\"vfb-55\" value=\"\" class=\"vfb-text  vfb-medium  required  digits \" \/><\/li>\n<li class=\"vfb-item vfb-item-text  \" id=\"item-vfb-66\"><label for=\"vfb-66\" class=\"vfb-desc\">Straatnaam + nr.  <span class=\"vfb-required-asterisk\">*<\/span><\/label><input type=\"text\" name=\"vfb-66\" id=\"vfb-66\" value=\"\" class=\"vfb-text  vfb-medium  required  \" \/><\/li>\n<li class=\"vfb-item vfb-item-text  \" id=\"item-vfb-53\"><label for=\"vfb-53\" class=\"vfb-desc\">Postcode  <span class=\"vfb-required-asterisk\">*<\/span><\/label><input type=\"text\" name=\"vfb-53\" id=\"vfb-53\" value=\"\" class=\"vfb-text  vfb-medium  required  \" \/><\/li>\n<li class=\"vfb-item vfb-item-email  \" id=\"item-vfb-57\"><label for=\"vfb-57\" class=\"vfb-desc\">Email  <span class=\"vfb-required-asterisk\">*<\/span><\/label><input type=\"email\" name=\"vfb-57\" id=\"vfb-57\" value=\"\" class=\"vfb-text  vfb-medium  required  email \" \/><\/li>\n<li class=\"vfb-item vfb-item-phone  \" id=\"item-vfb-58\"><label for=\"vfb-58\" class=\"vfb-desc\">Telefoon  <span class=\"vfb-required-asterisk\">*<\/span><\/label><input type=\"tel\" name=\"vfb-58\" id=\"vfb-58\" value=\"\" class=\"vfb-text  vfb-medium  required  phone \" \/><\/li>\n<li class=\"vfb-item vfb-item-text  \" id=\"item-vfb-59\"><label for=\"vfb-59\" class=\"vfb-desc\">Verzekeraar  <span class=\"vfb-required-asterisk\">*<\/span><\/label><input type=\"text\" name=\"vfb-59\" id=\"vfb-59\" value=\"\" class=\"vfb-text  vfb-medium  required  \" \/><\/li>\n<li class=\"vfb-item vfb-item-text  \" id=\"item-vfb-60\"><label for=\"vfb-60\" class=\"vfb-desc\">Polis nummer  <span class=\"vfb-required-asterisk\">*<\/span><\/label><input type=\"text\" name=\"vfb-60\" id=\"vfb-60\" value=\"\" class=\"vfb-text  vfb-medium  required  \" \/><\/li>\n<li class=\"vfb-item vfb-item-text  \" id=\"item-vfb-61\"><label for=\"vfb-61\" class=\"vfb-desc\">Huisarts  <span class=\"vfb-required-asterisk\">*<\/span><\/label><input type=\"text\" name=\"vfb-61\" id=\"vfb-61\" value=\"\" class=\"vfb-text  vfb-medium  required  \" \/><\/li>\n<li class=\"vfb-item vfb-item-radio  \" id=\"item-vfb-67\"><label class=\"vfb-desc\">Gebruik je medicijnen  <span class=\"vfb-required-asterisk\">*<\/span><\/label>\n<div><span class=\"vfb-span\"><input type=\"radio\" name=\"vfb-67\" id=\"vfb-67-1\" value=\"Ja\" class=\"vfb-radio  required \" \/><label for=\"vfb-67-1\" class=\"vfb-choice\">Ja<\/label><\/span><span class=\"vfb-span\"><input type=\"radio\" name=\"vfb-67\" id=\"vfb-67-2\" value=\"Nee\" class=\"vfb-radio  required \" \/><label for=\"vfb-67-2\" class=\"vfb-choice\">Nee<\/label><\/span><\/p>\n<div style=\"clear:both\"><\/div>\n<\/div>\n<\/li>\n<li class=\"vfb-item vfb-item-instructions  \" id=\"item-vfb-64\"><label class=\"vfb-desc\">Voorgeschiedenis <\/label>We vragen je naar je voorgeschiedenis om te beoordelen of het plaatsen van een spiraal bij jou mogelijk is.\n<p>Heb je:<\/li>\n<li class=\"vfb-item vfb-item-radio  \" id=\"item-vfb-68\"><label class=\"vfb-desc\">In het verleden een keizersnede gehad  <span class=\"vfb-required-asterisk\">*<\/span><\/label>\n<div><span class=\"vfb-span\"><input type=\"radio\" name=\"vfb-68\" id=\"vfb-68-1\" value=\"Ja\" class=\"vfb-radio  required \" \/><label for=\"vfb-68-1\" class=\"vfb-choice\">Ja<\/label><\/span><span class=\"vfb-span\"><input type=\"radio\" name=\"vfb-68\" id=\"vfb-68-2\" value=\"Nee\" class=\"vfb-radio  required \" \/><label for=\"vfb-68-2\" class=\"vfb-choice\">Nee<\/label><\/span><\/p>\n<div style=\"clear:both\"><\/div>\n<\/div>\n<\/li>\n<li class=\"vfb-item vfb-item-radio  \" id=\"item-vfb-70\"><label class=\"vfb-desc\">Eerder een spiraal gehad  <span class=\"vfb-required-asterisk\">*<\/span><\/label>\n<div><span class=\"vfb-span\"><input type=\"radio\" name=\"vfb-70\" id=\"vfb-70-1\" value=\"Ja\" class=\"vfb-radio  required \" \/><label for=\"vfb-70-1\" class=\"vfb-choice\">Ja<\/label><\/span><span class=\"vfb-span\"><input type=\"radio\" name=\"vfb-70\" id=\"vfb-70-2\" value=\"Nee\" class=\"vfb-radio  required \" \/><label for=\"vfb-70-2\" class=\"vfb-choice\">Nee<\/label><\/span><\/p>\n<div style=\"clear:both\"><\/div>\n<\/div>\n<\/li>\n<li class=\"vfb-item vfb-item-radio  \" id=\"item-vfb-71\"><label class=\"vfb-desc\">Hevige menstruatie  <span class=\"vfb-required-asterisk\">*<\/span><\/label>\n<div><span class=\"vfb-span\"><input type=\"radio\" name=\"vfb-71\" id=\"vfb-71-1\" value=\"Ja\" class=\"vfb-radio  required \" \/><label for=\"vfb-71-1\" class=\"vfb-choice\">Ja<\/label><\/span><span class=\"vfb-span\"><input type=\"radio\" name=\"vfb-71\" id=\"vfb-71-2\" value=\"Nee\" class=\"vfb-radio  required \" \/><label for=\"vfb-71-2\" class=\"vfb-choice\">Nee<\/label><\/span><\/p>\n<div style=\"clear:both\"><\/div>\n<\/div>\n<\/li>\n<li class=\"vfb-item vfb-item-radio  \" id=\"item-vfb-72\"><label class=\"vfb-desc\">Baarmoeder(mond) afwijking  <span class=\"vfb-required-asterisk\">*<\/span><\/label>\n<div><span class=\"vfb-span\"><input type=\"radio\" name=\"vfb-72\" id=\"vfb-72-1\" value=\"Ja\" class=\"vfb-radio  required \" \/><label for=\"vfb-72-1\" class=\"vfb-choice\">Ja<\/label><\/span><span class=\"vfb-span\"><input type=\"radio\" name=\"vfb-72\" id=\"vfb-72-2\" value=\"Nee\" class=\"vfb-radio  required \" \/><label for=\"vfb-72-2\" class=\"vfb-choice\">Nee<\/label><\/span><\/p>\n<div style=\"clear:both\"><\/div>\n<\/div>\n<\/li>\n<li class=\"vfb-item vfb-item-radio  \" id=\"item-vfb-73\"><label class=\"vfb-desc\">Koper allergie  <span class=\"vfb-required-asterisk\">*<\/span><\/label>\n<div><span class=\"vfb-span\"><input type=\"radio\" name=\"vfb-73\" id=\"vfb-73-1\" value=\"Ja\" class=\"vfb-radio  required \" \/><label for=\"vfb-73-1\" class=\"vfb-choice\">Ja<\/label><\/span><span class=\"vfb-span\"><input type=\"radio\" name=\"vfb-73\" id=\"vfb-73-2\" value=\"Nee\" class=\"vfb-radio  required \" \/><label for=\"vfb-73-2\" class=\"vfb-choice\">Nee<\/label><\/span><\/p>\n<div style=\"clear:both\"><\/div>\n<\/div>\n<\/li>\n<li class=\"vfb-item vfb-item-radio  \" id=\"item-vfb-74\"><label class=\"vfb-desc\">Latex allergie  <span class=\"vfb-required-asterisk\">*<\/span><\/label>\n<div><span class=\"vfb-span\"><input type=\"radio\" name=\"vfb-74\" id=\"vfb-74-1\" value=\"Ja\" class=\"vfb-radio  required \" \/><label for=\"vfb-74-1\" class=\"vfb-choice\">Ja<\/label><\/span><span class=\"vfb-span\"><input type=\"radio\" name=\"vfb-74\" id=\"vfb-74-2\" value=\"Nee\" class=\"vfb-radio  required \" \/><label for=\"vfb-74-2\" class=\"vfb-choice\">Nee<\/label><\/span><\/p>\n<div style=\"clear:both\"><\/div>\n<\/div>\n<\/li>\n<li class=\"vfb-item vfb-item-radio  \" id=\"item-vfb-75\"><label class=\"vfb-desc\">Diepe veneuze trombose (gehad)  <span class=\"vfb-required-asterisk\">*<\/span><\/label>\n<div><span class=\"vfb-span\"><input type=\"radio\" name=\"vfb-75\" id=\"vfb-75-1\" value=\"Ja\" class=\"vfb-radio  required \" \/><label for=\"vfb-75-1\" class=\"vfb-choice\">Ja<\/label><\/span><span class=\"vfb-span\"><input type=\"radio\" name=\"vfb-75\" id=\"vfb-75-2\" value=\"Nee\" class=\"vfb-radio  required \" \/><label for=\"vfb-75-2\" class=\"vfb-choice\">Nee<\/label><\/span><\/p>\n<div style=\"clear:both\"><\/div>\n<\/div>\n<\/li>\n<li class=\"vfb-item vfb-item-radio  \" id=\"item-vfb-76\"><label class=\"vfb-desc\">Longembolie (gehad  <span class=\"vfb-required-asterisk\">*<\/span><\/label>\n<div><span class=\"vfb-span\"><input type=\"radio\" name=\"vfb-76\" id=\"vfb-76-1\" value=\"Ja\" class=\"vfb-radio  required \" \/><label for=\"vfb-76-1\" class=\"vfb-choice\">Ja<\/label><\/span><span class=\"vfb-span\"><input type=\"radio\" name=\"vfb-76\" id=\"vfb-76-2\" value=\"Nee\" class=\"vfb-radio  required \" \/><label for=\"vfb-76-2\" class=\"vfb-choice\">Nee<\/label><\/span><\/p>\n<div style=\"clear:both\"><\/div>\n<\/div>\n<\/li>\n<li class=\"vfb-item vfb-item-radio  \" id=\"item-vfb-77\"><label class=\"vfb-desc\">Acute leveraandoening (gehad)  <span class=\"vfb-required-asterisk\">*<\/span><\/label>\n<div><span class=\"vfb-span\"><input type=\"radio\" name=\"vfb-77\" id=\"vfb-77-1\" value=\"Ja\" class=\"vfb-radio  required \" \/><label for=\"vfb-77-1\" class=\"vfb-choice\">Ja<\/label><\/span><span class=\"vfb-span\"><input type=\"radio\" name=\"vfb-77\" id=\"vfb-77-2\" value=\"Nee\" class=\"vfb-radio  required \" \/><label for=\"vfb-77-2\" class=\"vfb-choice\">Nee<\/label><\/span><\/p>\n<div style=\"clear:both\"><\/div>\n<\/div>\n<\/li>\n<li class=\"vfb-item vfb-item-radio  \" id=\"item-vfb-78\"><label class=\"vfb-desc\">Borstkanker (gehad)  <span class=\"vfb-required-asterisk\">*<\/span><\/label>\n<div><span class=\"vfb-span\"><input type=\"radio\" name=\"vfb-78\" id=\"vfb-78-1\" value=\"Ja\" class=\"vfb-radio  required \" \/><label for=\"vfb-78-1\" class=\"vfb-choice\">Ja<\/label><\/span><span class=\"vfb-span\"><input type=\"radio\" name=\"vfb-78\" id=\"vfb-78-2\" value=\"Nee\" class=\"vfb-radio  required \" \/><label for=\"vfb-78-2\" class=\"vfb-choice\">Nee<\/label><\/span><\/p>\n<div style=\"clear:both\"><\/div>\n<\/div>\n<\/li>\n<li class=\"vfb-item vfb-item-radio  \" id=\"item-vfb-79\"><label class=\"vfb-desc\">Mogelijk nu een geslachtsziekte  <span class=\"vfb-required-asterisk\">*<\/span><\/label>\n<div><span class=\"vfb-span\"><input type=\"radio\" name=\"vfb-79\" id=\"vfb-79-1\" value=\"Ja\" class=\"vfb-radio  required \" \/><label for=\"vfb-79-1\" class=\"vfb-choice\">Ja<\/label><\/span><span class=\"vfb-span\"><input type=\"radio\" name=\"vfb-79\" id=\"vfb-79-2\" value=\"Nee\" class=\"vfb-radio  required \" \/><label for=\"vfb-79-2\" class=\"vfb-choice\">Nee<\/label><\/span><\/p>\n<div style=\"clear:both\"><\/div>\n<\/div>\n<\/li>\n<li class=\"vfb-item vfb-item-radio  \" id=\"item-vfb-80\"><label class=\"vfb-desc\">Een keuze gemaakt welke spiraal  <span class=\"vfb-required-asterisk\">*<\/span><\/label>\n<div><span class=\"vfb-span\"><input type=\"radio\" name=\"vfb-80\" id=\"vfb-80-1\" value=\"Ja\" class=\"vfb-radio  required \" \/><label for=\"vfb-80-1\" class=\"vfb-choice\">Ja<\/label><\/span><span class=\"vfb-span\"><input type=\"radio\" name=\"vfb-80\" id=\"vfb-80-2\" value=\"Nee\" class=\"vfb-radio  required \" \/><label for=\"vfb-80-2\" class=\"vfb-choice\">Nee<\/label><\/span><\/p>\n<div style=\"clear:both\"><\/div>\n<\/div>\n<\/li>\n<li class=\"vfb-item vfb-item-text  \" id=\"item-vfb-81\"><label for=\"vfb-81\" class=\"vfb-desc\">Zo ja, welke? <\/label><input type=\"text\" name=\"vfb-81\" id=\"vfb-81\" value=\"\" class=\"vfb-text  vfb-medium   \" \/><\/li>\n<li class=\"vfb-item vfb-item-radio  \" id=\"item-vfb-82\"><label class=\"vfb-desc\">Recent een bevalling gehad  <span class=\"vfb-required-asterisk\">*<\/span><\/label>\n<div><span class=\"vfb-span\"><input type=\"radio\" name=\"vfb-82\" id=\"vfb-82-1\" value=\"Ja\" class=\"vfb-radio  required \" \/><label for=\"vfb-82-1\" class=\"vfb-choice\">Ja<\/label><\/span><span class=\"vfb-span\"><input type=\"radio\" name=\"vfb-82\" id=\"vfb-82-2\" value=\"Nee\" class=\"vfb-radio  required \" \/><label for=\"vfb-82-2\" class=\"vfb-choice\">Nee<\/label><\/span><\/p>\n<div style=\"clear:both\"><\/div>\n<\/div>\n<\/li>\n<li class=\"vfb-item vfb-item-date  \" id=\"item-vfb-83\"><label for=\"vfb-83\" class=\"vfb-desc\">Datum van bevalling (indien van toepassing) <\/label><input type=\"text\" name=\"vfb-83\" id=\"vfb-83\" value=\"\" class=\"vfb-text vfb-date-picker  vfb-medium  \" data-dp-dateFormat=\"dd\/mm\/yyyy\" \/><\/li>\n<li class=\"vfb-item vfb-item-radio  \" id=\"item-vfb-84\"><label class=\"vfb-desc\">Wijze van bevalling (indien van toepassing) <\/label>\n<div><span class=\"vfb-span\"><input type=\"radio\" name=\"vfb-84\" id=\"vfb-84-1\" value=\"Vaginaal\" class=\"vfb-radio  \" \/><label for=\"vfb-84-1\" class=\"vfb-choice\">Vaginaal<\/label><\/span><span class=\"vfb-span\"><input type=\"radio\" name=\"vfb-84\" id=\"vfb-84-2\" value=\"Keizersnede\" class=\"vfb-radio  \" \/><label for=\"vfb-84-2\" class=\"vfb-choice\">Keizersnede<\/label><\/span><span class=\"vfb-span\"><input type=\"radio\" name=\"vfb-84\" id=\"vfb-84-3\" value=\"Niet van toepassing\" class=\"vfb-radio  \" \/><label for=\"vfb-84-3\" class=\"vfb-choice\">Niet van toepassing<\/label><\/span><\/p>\n<div style=\"clear:both\"><\/div>\n<\/div>\n<\/li>\n<li class=\"vfb-item vfb-item-radio  \" id=\"item-vfb-85\"><label class=\"vfb-desc\">AVG  <span class=\"vfb-required-asterisk\">*<\/span><\/label>\n<div><span><label>Ik geef toestemming om mijn gegevens te verzamelen.<\/label><\/span><span class=\"vfb-span\"><input type=\"radio\" name=\"vfb-85\" id=\"vfb-85-1\" value=\"Ja\" class=\"vfb-radio  required \" \/><label for=\"vfb-85-1\" class=\"vfb-choice\">Ja<\/label><\/span><\/p>\n<div style=\"clear:both\"><\/div>\n<\/div>\n<\/li>\n<\/ul>\n<p>&nbsp;<\/fieldset>\n<fieldset class=\"vfb-fieldset vfb-fieldset-2 verificatie \" id=\"item-vfb-47\" style=\"display:block\">\n<div class=\"vfb-legend\">\n<h3>Verificatie<\/h3>\n<\/div>\n<ul class=\"vfb-section vfb-section-2\">\n<li class=\"vfb-item vfb-item-secret\"  style=\"display:block\"><label for=\"vfb-48\" class=\"vfb-desc\">Vul twee willekeurige cijfers in ter verificatie <span class=\"vfb-required-asterisk\">*<\/span><\/label><input type=\"hidden\" name=\"_vfb-secret\" value=\"vfb-48\" \/><span class=\"vfb-span\"><input type=\"text\" name=\"vfb-48\" id=\"vfb-48\" value=\"\" class=\"vfb-text  vfb-medium  required {digits:true,maxlength:2,minlength:2} \" style=\"display:block\" \/><label>Bijvoorbeeld: 34 of 21<\/label><\/span>\n<li style=\"display:none;\"><label>Deze ruimte is voor spam beveiliging &#8211; &lt;strong&gt;a.u.b. blanko laten&lt;\/strong&gt;:<\/label>\n<div><input name=\"vfb-spam\" \/><\/div>\n<\/li>\n<li class=\"vfb-item vfb-item-submit\" id=\"item-vfb-49\">\n\t\t\t\t<input type=\"submit\" name=\"vfb-submit\" id=\"vfb-49\" value=\"Versturen\" class=\"vfb-submit \" \/>\n\t\t\t\t<\/li>\n<\/ul>\n<\/fieldset>\n<p><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/site21\/wp-json\/wp\/v2\/pages\/12280\" \/><\/form>\n<\/div>\n<p> <!-- .visual-form-builder-container --><\/p>\n<\/p>\t\t\t\t\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<section class=\"elementor-section elementor-top-section elementor-element elementor-element-e5ef6cd elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"e5ef6cd\" data-element_type=\"section\" data-e-type=\"section\">\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-0fd31f3\" data-id=\"0fd31f3\" 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-1b0dbe5 elementor-widget elementor-widget-text-editor\" data-id=\"1b0dbe5\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>Dit aanmeldformulier vraagt je om persoonsgegevens die nodig zijn voor het aanmaken van een cli\u00ebntendossier. Je gegevens worden worden nooit aan derden verstrekt. Zie onze <a href=\"\/wordpress\/disclaimer\/\">Privacyverklaring<\/a> om te zien hoe wij met jou gegevens omgaan.<\/p>\t\t\t\t\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>Spiraaltje Plaatsen MELD JE AAN VIA HET ONLINE AANMELDFORMULIER Dit&hellip;<\/p>\n<p> <a class=\"more-link\" href=\"https:\/\/verloskundigenpraktijkdehof.nl\/site21\/aanmeldformulier-plaatsen-spiraaltje\/\">Lees verder<\/a><\/p>\n","protected":false},"author":4,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-12280","page","type-page","status-publish"],"_links":{"self":[{"href":"https:\/\/verloskundigenpraktijkdehof.nl\/site21\/wp-json\/wp\/v2\/pages\/12280","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/verloskundigenpraktijkdehof.nl\/site21\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/verloskundigenpraktijkdehof.nl\/site21\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/verloskundigenpraktijkdehof.nl\/site21\/wp-json\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/verloskundigenpraktijkdehof.nl\/site21\/wp-json\/wp\/v2\/comments?post=12280"}],"version-history":[{"count":11,"href":"https:\/\/verloskundigenpraktijkdehof.nl\/site21\/wp-json\/wp\/v2\/pages\/12280\/revisions"}],"predecessor-version":[{"id":12325,"href":"https:\/\/verloskundigenpraktijkdehof.nl\/site21\/wp-json\/wp\/v2\/pages\/12280\/revisions\/12325"}],"wp:attachment":[{"href":"https:\/\/verloskundigenpraktijkdehof.nl\/site21\/wp-json\/wp\/v2\/media?parent=12280"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}