{"id":546,"date":"2021-06-01T11:48:04","date_gmt":"2021-06-01T10:48:04","guid":{"rendered":"https:\/\/dewittebrug.net\/?page_id=546"},"modified":"2021-06-15T15:31:31","modified_gmt":"2021-06-15T14:31:31","slug":"inschrijven","status":"publish","type":"page","link":"https:\/\/dewittebrug.net\/inschrijven\/","title":{"rendered":"Inschrijven"},"content":{"rendered":"<section class=\"wpb-content-wrapper\"><p>[vc_row row_height_percent=&#8221;0&#8243; override_padding=&#8221;yes&#8221; h_padding=&#8221;2&#8243; top_padding=&#8221;0&#8243; bottom_padding=&#8221;2&#8243; overlay_alpha=&#8221;50&#8243; gutter_size=&#8221;3&#8243; column_width_percent=&#8221;100&#8243; shift_y=&#8221;0&#8243; z_index=&#8221;0&#8243; inverted_device_order=&#8221;yes&#8221;][vc_column column_width_percent=&#8221;100&#8243; position_vertical=&#8221;middle&#8221; gutter_size=&#8221;3&#8243; overlay_alpha=&#8221;50&#8243; shift_x=&#8221;0&#8243; shift_y=&#8221;0&#8243; shift_y_down=&#8221;0&#8243; z_index=&#8221;0&#8243; medium_width=&#8221;0&#8243; mobile_width=&#8221;0&#8243; width=&#8221;1\/3&#8243;][vc_custom_heading heading_semantic=&#8221;h1&#8243; text_color=&#8221;color-184510&#8243; el_class=&#8221;header-mobile&#8221;]Inschrijven[\/vc_custom_heading][vc_column_text]De Witte Brug is een moderne groepspraktijk voor algemene tandheelkunde. Je gebit is een belangrijk onderdeel van je lichaam met essenti\u00eble functies als kauwen en praten.[\/vc_column_text][vc_icon position=&#8221;left&#8221; icon=&#8221;fa fa-arrow-right4&#8243; icon_color=&#8221;color-935926&#8243; size=&#8221;fa-3x&#8221; heading_semantic=&#8221;p&#8221; text_font=&#8221;font-148056&#8243; text_size=&#8221;&#8221; text_weight=&#8221;600&#8243; linked_title=&#8221;yes&#8221; title=&#8221;Schrijf u in bij onze praktijk&#8221; link=&#8221;url:%23inschrijven&#8221;][\/vc_icon][\/vc_column][vc_column column_width_percent=&#8221;100&#8243; gutter_size=&#8221;3&#8243; overlay_alpha=&#8221;50&#8243; shift_x=&#8221;0&#8243; shift_y=&#8221;3&#8243; shift_y_down=&#8221;0&#8243; z_index=&#8221;0&#8243; medium_width=&#8221;0&#8243; mobile_width=&#8221;0&#8243; width=&#8221;2\/3&#8243;][vc_single_image media=&#8221;485&#8243; media_width_percent=&#8221;100&#8243;][\/vc_column][\/vc_row][vc_row row_height_percent=&#8221;0&#8243; override_padding=&#8221;yes&#8221; h_padding=&#8221;2&#8243; top_padding=&#8221;4&#8243; bottom_padding=&#8221;4&#8243; back_color=&#8221;color-125678&#8243; overlay_alpha=&#8221;50&#8243; gutter_size=&#8221;3&#8243; column_width_percent=&#8221;100&#8243; shift_y=&#8221;0&#8243; z_index=&#8221;0&#8243; row_custom_slug_check=&#8221;yes&#8221; el_class=&#8221;inschrijven&#8221; row_name=&#8221;inschrijven&#8221; row_custom_slug=&#8221;inschrijven&#8221; el_id=&#8221;inschrijven&#8221;][vc_column width=&#8221;1\/6&#8243;][\/vc_column][vc_column width=&#8221;4\/6&#8243;][vc_custom_heading]Inschrijven[\/vc_custom_heading][vc_column_text]De onderstaande gegevens zijn noodzakelijk voor een correcte administratie en worden door ons strikt vertrouwelijk behandeld.<\/p>\n<p>Vriendelijk verzoeken wij u een geldig legitimatiebewijs mee te nemen bij uw eerste bezoek aan onze praktijk.[\/vc_column_text]<div class=\"wpforms-container wpforms-container-full wpcf7-form init\" id=\"wpforms-665\"><form id=\"wpforms-form-665\" class=\"wpforms-validate wpforms-form\" data-formid=\"665\" method=\"post\" enctype=\"multipart\/form-data\" action=\"\/wp-json\/wp\/v2\/pages\/546\/\" data-token=\"c9f74ee2b5ab2e04897dd29bbfb65e61\" data-token-time=\"1744689081\"><noscript class=\"wpforms-error-noscript\">Schakel JavaScript in je browser in om dit formulier in te vullen.<\/noscript><div class=\"wpforms-field-container\"><div id=\"wpforms-665-field_36-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"36\"><label class=\"wpforms-field-label\" for=\"wpforms-665-field_36\">** Gelieve het hele formulier in te vullen<\/label><input type=\"text\" id=\"wpforms-665-field_36\" class=\"wpforms-field-medium\" name=\"wpforms[fields][36]\" ><\/div><div id=\"wpforms-665-field_35-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"35\"><label class=\"wpforms-field-label\" for=\"wpforms-665-field_35\">Voorletters<\/label><input type=\"text\" id=\"wpforms-665-field_35\" class=\"wpforms-field-medium\" name=\"wpforms[fields][35]\" ><\/div><div id=\"wpforms-665-field_2-container\" class=\"wpforms-field wpforms-field-name wpforms-one-half wpforms-first\" data-field-id=\"2\"><label class=\"wpforms-field-label\" for=\"wpforms-665-field_2\">Naam <span class=\"wpforms-required-label\">*<\/span><\/label><div class=\"wpforms-field-row wpforms-field-medium\"><div class=\"wpforms-field-row-block wpforms-first wpforms-one-half\"><input type=\"text\" id=\"wpforms-665-field_2\" class=\"wpforms-field-name-first wpforms-field-required\" name=\"wpforms[fields][2][first]\" required><label for=\"wpforms-665-field_2\" class=\"wpforms-field-sublabel after\">Voornaam<\/label><\/div><div class=\"wpforms-field-row-block wpforms-one-half\"><input type=\"text\" id=\"wpforms-665-field_2-last\" class=\"wpforms-field-name-last wpforms-field-required\" name=\"wpforms[fields][2][last]\" required><label for=\"wpforms-665-field_2-last\" class=\"wpforms-field-sublabel after\">Achternaam<\/label><\/div><\/div><\/div><div id=\"wpforms-665-field_34-container\" class=\"wpforms-field wpforms-field-email\" data-field-id=\"34\"><label class=\"wpforms-field-label\" for=\"wpforms-665-field_34\">E-mail <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"email\" id=\"wpforms-665-field_34\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][34]\" spellcheck=\"false\" required><\/div><div id=\"wpforms-665-field_5-container\" class=\"wpforms-field wpforms-field-checkbox\" data-field-id=\"5\"><label class=\"wpforms-field-label\">Checkboxes<\/label><ul id=\"wpforms-665-field_5\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-665-field_5_1\" name=\"wpforms[fields][5][]\" value=\"Man\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-665-field_5_1\">Man<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"checkbox\" id=\"wpforms-665-field_5_2\" name=\"wpforms[fields][5][]\" value=\"Vrouw\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-665-field_5_2\">Vrouw<\/label><\/li><\/ul><\/div><div id=\"wpforms-665-field_6-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"6\"><label class=\"wpforms-field-label\" for=\"wpforms-665-field_6\">Geboortedatum<\/label><input type=\"text\" id=\"wpforms-665-field_6\" class=\"wpforms-field-medium\" name=\"wpforms[fields][6]\" placeholder=\"dag\/maand\/jaar\" ><\/div><div id=\"wpforms-665-field_7-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"7\"><label class=\"wpforms-field-label\" for=\"wpforms-665-field_7\">Adres en huisnummer<\/label><input type=\"text\" id=\"wpforms-665-field_7\" class=\"wpforms-field-medium\" name=\"wpforms[fields][7]\" ><\/div><div id=\"wpforms-665-field_8-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"8\"><label class=\"wpforms-field-label\" for=\"wpforms-665-field_8\">Postcode<\/label><input type=\"text\" id=\"wpforms-665-field_8\" class=\"wpforms-field-small wpforms-masked-input\" data-rule-inputmask-incomplete=\"1\" data-inputmask-mask=\"9999aa\" name=\"wpforms[fields][8]\" ><\/div><div id=\"wpforms-665-field_9-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"9\"><label class=\"wpforms-field-label\" for=\"wpforms-665-field_9\">Woonplaats<\/label><input type=\"text\" id=\"wpforms-665-field_9\" class=\"wpforms-field-medium\" name=\"wpforms[fields][9]\" ><\/div><div id=\"wpforms-665-field_11-container\" class=\"wpforms-field wpforms-field-number\" data-field-id=\"11\"><label class=\"wpforms-field-label\" for=\"wpforms-665-field_11\">Telefoon prive<\/label><input type=\"number\" id=\"wpforms-665-field_11\" class=\"wpforms-field-medium\" name=\"wpforms[fields][11]\" ><\/div><div id=\"wpforms-665-field_10-container\" class=\"wpforms-field wpforms-field-number\" data-field-id=\"10\"><label class=\"wpforms-field-label\" for=\"wpforms-665-field_10\">Telefoon mobiel<\/label><input type=\"number\" id=\"wpforms-665-field_10\" class=\"wpforms-field-medium\" name=\"wpforms[fields][10]\" ><\/div><div id=\"wpforms-665-field_12-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"12\"><label class=\"wpforms-field-label\" for=\"wpforms-665-field_12\">BSN-nummer<\/label><input type=\"text\" id=\"wpforms-665-field_12\" class=\"wpforms-field-medium\" name=\"wpforms[fields][12]\" ><\/div><div id=\"wpforms-665-field_13-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"13\"><label class=\"wpforms-field-label\" for=\"wpforms-665-field_13\">Verzekeringsfirma<\/label><input type=\"text\" id=\"wpforms-665-field_13\" class=\"wpforms-field-medium\" name=\"wpforms[fields][13]\" ><\/div><div id=\"wpforms-665-field_14-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"14\"><label class=\"wpforms-field-label\" for=\"wpforms-665-field_14\">Verzekeringsnummer<\/label><input type=\"text\" id=\"wpforms-665-field_14\" class=\"wpforms-field-medium\" name=\"wpforms[fields][14]\" ><\/div><div id=\"wpforms-665-field_15-container\" class=\"wpforms-field wpforms-field-checkbox\" data-field-id=\"15\"><label class=\"wpforms-field-label\">Bent u verzekerd voor de tandarts<\/label><ul id=\"wpforms-665-field_15\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-665-field_15_1\" name=\"wpforms[fields][15][]\" value=\"Ja\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-665-field_15_1\">Ja<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"checkbox\" id=\"wpforms-665-field_15_2\" name=\"wpforms[fields][15][]\" value=\"Nee\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-665-field_15_2\">Nee<\/label><\/li><\/ul><\/div><div id=\"wpforms-665-field_17-container\" class=\"wpforms-field wpforms-field-number\" data-field-id=\"17\"><label class=\"wpforms-field-label\" for=\"wpforms-665-field_17\">Jaartal laatste bezoek tandarts<\/label><input type=\"number\" id=\"wpforms-665-field_17\" class=\"wpforms-field-medium\" name=\"wpforms[fields][17]\" ><\/div><div id=\"wpforms-665-field_16-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"16\"><label class=\"wpforms-field-label\" for=\"wpforms-665-field_16\">Huisarts<\/label><input type=\"text\" id=\"wpforms-665-field_16\" class=\"wpforms-field-medium\" name=\"wpforms[fields][16]\" ><\/div><div id=\"wpforms-665-field_33-container\" class=\"wpforms-field wpforms-field-select wpforms-field-select-style-classic\" data-field-id=\"33\"><label class=\"wpforms-field-label\" for=\"wpforms-665-field_33\">Voorkeur tandarts<\/label><select id=\"wpforms-665-field_33\" class=\"wpforms-field-medium\" name=\"wpforms[fields][33]\"><option value=\"n.v.t.\" >n.v.t.<\/option><option value=\"Albert Tertoolen\" >Albert Tertoolen<\/option><option value=\"Bart Defossez\" >Bart Defossez<\/option><option value=\"Bart van der Linden\" >Bart van der Linden<\/option><option value=\"Martijn Croon\" >Martijn Croon<\/option><\/select><\/div><div id=\"wpforms-665-field_18-container\" class=\"wpforms-field wpforms-field-checkbox\" data-field-id=\"18\"><label class=\"wpforms-field-label\">Hoe bent u bij ons terecht gekomen?<\/label><ul id=\"wpforms-665-field_18\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-665-field_18_1\" name=\"wpforms[fields][18][]\" value=\"Viavia\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-665-field_18_1\">Viavia<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"checkbox\" id=\"wpforms-665-field_18_2\" name=\"wpforms[fields][18][]\" value=\"Google\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-665-field_18_2\">Google<\/label><\/li><li class=\"choice-3 depth-1\"><input type=\"checkbox\" id=\"wpforms-665-field_18_3\" name=\"wpforms[fields][18][]\" value=\"Tandarts.nl\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-665-field_18_3\">Tandarts.nl<\/label><\/li><li class=\"choice-4 depth-1\"><input type=\"checkbox\" id=\"wpforms-665-field_18_4\" name=\"wpforms[fields][18][]\" value=\"Advertentie\/actie\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-665-field_18_4\">Advertentie\/actie<\/label><\/li><\/ul><\/div><div id=\"wpforms-665-field_19-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"19\"><label class=\"wpforms-field-label\" for=\"wpforms-665-field_19\">Anders namelijk<\/label><input type=\"text\" id=\"wpforms-665-field_19\" class=\"wpforms-field-medium\" name=\"wpforms[fields][19]\" ><\/div><div id=\"wpforms-665-field_21-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"21\"><label class=\"wpforms-field-label\" for=\"wpforms-665-field_21\">Medisch dossier<\/label><input type=\"text\" id=\"wpforms-665-field_21\" class=\"wpforms-field-medium\" name=\"wpforms[fields][21]\" ><div class=\"wpforms-field-description\">Uw gezondheid en het gebruik van geneesmiddelen kunnen van belang zijn bij een tandheelkundige behandeling. Wilt u zo vriendelijk zijn om onderstaande vragen te beantwoorden?<\/div><\/div><div id=\"wpforms-665-field_22-container\" class=\"wpforms-field wpforms-field-checkbox\" data-field-id=\"22\"><label class=\"wpforms-field-label\">Bent u onder behandeling van huisarts of specialist?<\/label><ul id=\"wpforms-665-field_22\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-665-field_22_1\" name=\"wpforms[fields][22][]\" value=\"Ja\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-665-field_22_1\">Ja<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"checkbox\" id=\"wpforms-665-field_22_2\" name=\"wpforms[fields][22][]\" value=\"Nee\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-665-field_22_2\">Nee<\/label><\/li><\/ul><\/div><div id=\"wpforms-665-field_23-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"23\"><label class=\"wpforms-field-label\" for=\"wpforms-665-field_23\">Zo ja, bij wie en waarvoor?<\/label><textarea id=\"wpforms-665-field_23\" class=\"wpforms-field-medium\" name=\"wpforms[fields][23]\" ><\/textarea><\/div><div id=\"wpforms-665-field_24-container\" class=\"wpforms-field wpforms-field-radio\" data-field-id=\"24\"><label class=\"wpforms-field-label\">Lijdt u aan of heeft u geleden aan een van de onderstaande ziekten?<\/label><ul id=\"wpforms-665-field_24\"><li class=\"choice-1 depth-1\"><input type=\"radio\" id=\"wpforms-665-field_24_1\" name=\"wpforms[fields][24]\" value=\"Chronische of acuut reuma\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-665-field_24_1\">Chronische of acuut reuma<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"radio\" id=\"wpforms-665-field_24_2\" name=\"wpforms[fields][24]\" value=\"Astma\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-665-field_24_2\">Astma<\/label><\/li><li class=\"choice-3 depth-1\"><input type=\"radio\" id=\"wpforms-665-field_24_3\" name=\"wpforms[fields][24]\" value=\"Suikerziekte\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-665-field_24_3\">Suikerziekte<\/label><\/li><li class=\"choice-7 depth-1\"><input type=\"radio\" id=\"wpforms-665-field_24_7\" name=\"wpforms[fields][24]\" value=\"Nierafwijking\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-665-field_24_7\">Nierafwijking<\/label><\/li><li class=\"choice-6 depth-1\"><input type=\"radio\" id=\"wpforms-665-field_24_6\" name=\"wpforms[fields][24]\" value=\"Hart- of vaatziekte\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-665-field_24_6\">Hart- of vaatziekte<\/label><\/li><li class=\"choice-5 depth-1\"><input type=\"radio\" id=\"wpforms-665-field_24_5\" name=\"wpforms[fields][24]\" value=\"Schildklierafwijking\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-665-field_24_5\">Schildklierafwijking<\/label><\/li><li class=\"choice-4 depth-1\"><input type=\"radio\" id=\"wpforms-665-field_24_4\" name=\"wpforms[fields][24]\" value=\"Een beroerte gehad\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-665-field_24_4\">Een beroerte gehad<\/label><\/li><li class=\"choice-8 depth-1\"><input type=\"radio\" id=\"wpforms-665-field_24_8\" name=\"wpforms[fields][24]\" value=\"Leverziekte c.q. geelzucht\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-665-field_24_8\">Leverziekte c.q. geelzucht<\/label><\/li><\/ul><\/div><div id=\"wpforms-665-field_25-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"25\"><label class=\"wpforms-field-label\" for=\"wpforms-665-field_25\">Andere ziekten namelijk<\/label><input type=\"text\" id=\"wpforms-665-field_25\" class=\"wpforms-field-medium\" name=\"wpforms[fields][25]\" ><\/div><div id=\"wpforms-665-field_26-container\" class=\"wpforms-field wpforms-field-checkbox\" data-field-id=\"26\"><label class=\"wpforms-field-label\">Heeft u voor een tandheelkundige behandeling een antibioticum bescherming nodig? (Dit is nodig bij: vaat- of hartklepprothese, kunstheup, aangeboren hartafwijking)<\/label><ul id=\"wpforms-665-field_26\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-665-field_26_1\" name=\"wpforms[fields][26][]\" value=\"Nee\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-665-field_26_1\">Nee<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"checkbox\" id=\"wpforms-665-field_26_2\" name=\"wpforms[fields][26][]\" value=\"Ja\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-665-field_26_2\">Ja<\/label><\/li><\/ul><\/div><div id=\"wpforms-665-field_27-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"27\"><label class=\"wpforms-field-label\" for=\"wpforms-665-field_27\">Gebruikt u medicijnen? Zo ja, welke?<\/label><input type=\"text\" id=\"wpforms-665-field_27\" class=\"wpforms-field-medium\" name=\"wpforms[fields][27]\" ><\/div><div id=\"wpforms-665-field_28-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"28\"><label class=\"wpforms-field-label\" for=\"wpforms-665-field_28\">Bent u overgevoelig voor medicijnen of andere stoffen? Zo ja, welke?<\/label><input type=\"text\" id=\"wpforms-665-field_28\" class=\"wpforms-field-medium\" name=\"wpforms[fields][28]\" ><\/div><div id=\"wpforms-665-field_29-container\" class=\"wpforms-field wpforms-field-checkbox\" data-field-id=\"29\"><label class=\"wpforms-field-label\">Bent u in verwachting?<\/label><ul id=\"wpforms-665-field_29\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-665-field_29_1\" name=\"wpforms[fields][29][]\" value=\"Ja\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-665-field_29_1\">Ja<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"checkbox\" id=\"wpforms-665-field_29_2\" name=\"wpforms[fields][29][]\" value=\"Nee\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-665-field_29_2\">Nee<\/label><\/li><\/ul><\/div><div id=\"wpforms-665-field_30-container\" class=\"wpforms-field wpforms-field-checkbox\" data-field-id=\"30\"><label class=\"wpforms-field-label\">Lijdt u aan een besmettelijke ziekte?<\/label><ul id=\"wpforms-665-field_30\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-665-field_30_1\" name=\"wpforms[fields][30][]\" value=\"Ja\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-665-field_30_1\">Ja<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"checkbox\" id=\"wpforms-665-field_30_2\" name=\"wpforms[fields][30][]\" value=\"Nee\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-665-field_30_2\">Nee<\/label><\/li><\/ul><\/div><div id=\"wpforms-665-field_31-container\" class=\"wpforms-field wpforms-field-checkbox\" data-field-id=\"31\"><label class=\"wpforms-field-label\">Heeft u wel eens een nabloeding gehad?<\/label><ul id=\"wpforms-665-field_31\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-665-field_31_1\" name=\"wpforms[fields][31][]\" value=\"Ja\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-665-field_31_1\">Ja<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"checkbox\" id=\"wpforms-665-field_31_2\" name=\"wpforms[fields][31][]\" value=\"Nee\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-665-field_31_2\">Nee<\/label><\/li><\/ul><\/div><div id=\"wpforms-665-field_32-container\" class=\"wpforms-field wpforms-field-checkbox\" data-field-id=\"32\"><label class=\"wpforms-field-label\">Bent u ooit bestraald of heeft u een chemotherapie ondergaan?<\/label><ul id=\"wpforms-665-field_32\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-665-field_32_1\" name=\"wpforms[fields][32][]\" value=\"Ja\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-665-field_32_1\">Ja<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"checkbox\" id=\"wpforms-665-field_32_2\" name=\"wpforms[fields][32][]\" value=\"Nee\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-665-field_32_2\">Nee<\/label><\/li><\/ul><\/div><\/div><!-- .wpforms-field-container --><div class=\"wpforms-recaptcha-container wpforms-is-recaptcha wpforms-is-recaptcha-type-v3\" ><input type=\"hidden\" name=\"wpforms[recaptcha]\" value=\"\"><\/div><div class=\"wpforms-submit-container\" ><input type=\"hidden\" name=\"wpforms[id]\" value=\"665\"><input type=\"hidden\" name=\"page_title\" value=\"\"><input type=\"hidden\" name=\"page_url\" value=\"https:\/\/dewittebrug.net\/wp-json\/wp\/v2\/pages\/546\/\"><button type=\"submit\" name=\"wpforms[submit]\" id=\"wpforms-submit-665\" class=\"wpforms-submit wpcf7-form-control wpcf7-submit btn btn-accent send\" data-alt-text=\"Verzenden...\" data-submit-text=\"Verstuur\" aria-live=\"assertive\" value=\"wpforms-submit\">Verstuur<\/button><\/div><\/form><\/div>  <!-- .wpforms-container -->[\/vc_column][vc_column width=&#8221;1\/6&#8243;][\/vc_column][\/vc_row]<\/p>\n<\/section>","protected":false},"excerpt":{"rendered":"<p>[vc_row row_height_percent=&#8221;0&#8243; override_padding=&#8221;yes&#8221; h_padding=&#8221;2&#8243; top_padding=&#8221;0&#8243; bottom_padding=&#8221;2&#8243; overlay_alpha=&#8221;50&#8243; gutter_size=&#8221;3&#8243; column_width_percent=&#8221;100&#8243; shift_y=&#8221;0&#8243; z_index=&#8221;0&#8243; inverted_device_order=&#8221;yes&#8221;][vc_column column_width_percent=&#8221;100&#8243; position_vertical=&#8221;middle&#8221; gutter_size=&#8221;3&#8243; overlay_alpha=&#8221;50&#8243; shift_x=&#8221;0&#8243; shift_y=&#8221;0&#8243; shift_y_down=&#8221;0&#8243; z_index=&#8221;0&#8243; [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-546","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/dewittebrug.net\/wp-json\/wp\/v2\/pages\/546","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/dewittebrug.net\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/dewittebrug.net\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/dewittebrug.net\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/dewittebrug.net\/wp-json\/wp\/v2\/comments?post=546"}],"version-history":[{"count":4,"href":"https:\/\/dewittebrug.net\/wp-json\/wp\/v2\/pages\/546\/revisions"}],"predecessor-version":[{"id":701,"href":"https:\/\/dewittebrug.net\/wp-json\/wp\/v2\/pages\/546\/revisions\/701"}],"wp:attachment":[{"href":"https:\/\/dewittebrug.net\/wp-json\/wp\/v2\/media?parent=546"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}