{"id":208,"date":"2024-03-27T20:27:46","date_gmt":"2024-03-27T19:27:46","guid":{"rendered":"https:\/\/korves.fcm-it.de\/?page_id=208"},"modified":"2024-03-27T20:27:46","modified_gmt":"2024-03-27T19:27:46","slug":"terminanfrage","status":"publish","type":"page","link":"https:\/\/mrt-korves.de\/index.php\/terminanfrage\/","title":{"rendered":"Terminanfrage"},"content":{"rendered":"<div class=\"forminator-ui forminator-custom-form forminator-custom-form-207 forminator-design--default  forminator_ajax\" data-forminator-render=\"0\" data-form=\"forminator-module-207\" data-uid=\"69e1b47b2b6a3\"><br\/><\/div><form\n\t\t\t\tid=\"forminator-module-207\"\n\t\t\t\tclass=\"forminator-ui forminator-custom-form forminator-custom-form-207 forminator-design--default  forminator_ajax\"\n\t\t\t\tmethod=\"post\"\n\t\t\t\tdata-forminator-render=\"0\"\n\t\t\t\tdata-form-id=\"207\"\n\t\t\t\tenctype=\"multipart\/form-data\" data-color-option=\"default\" data-design=\"default\" data-grid=\"open\" style=\"display: none;\"\n\t\t\t\tdata-uid=\"69e1b47b2b6a3\"\n\t\t\t><div role=\"alert\" aria-live=\"polite\" class=\"forminator-response-message forminator-error\" aria-hidden=\"true\"><\/div><div class=\"forminator-row\"><div id=\"name-1\" class=\"forminator-field-name forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-name-1_69e1b47b2b6a3\" id=\"forminator-field-name-1_69e1b47b2b6a3-label\" class=\"forminator-label\">Name <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"name-1\" value=\"\" placeholder=\"z.B. Max Mustermann\" id=\"forminator-field-name-1_69e1b47b2b6a3\" class=\"forminator-input forminator-name--field\" aria-required=\"true\" autocomplete=\"name\" \/><\/div><\/div><div id=\"email-1\" class=\"forminator-field-email forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-email-1_69e1b47b2b6a3\" id=\"forminator-field-email-1_69e1b47b2b6a3-label\" class=\"forminator-label\">E-Mail Adresse <span class=\"forminator-required\">*<\/span><\/label><input type=\"email\" name=\"email-1\" value=\"\" placeholder=\"z.B. Max@Mustermann.de\" id=\"forminator-field-email-1_69e1b47b2b6a3\" class=\"forminator-input forminator-email--field\" data-required=\"true\" aria-required=\"true\" autocomplete=\"email\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"phone-1\" class=\"forminator-field-phone forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-phone-1_69e1b47b2b6a3\" id=\"forminator-field-phone-1_69e1b47b2b6a3-label\" class=\"forminator-label\">R\u00fcckrufnummer f\u00fcr eine Terminvergabe notwendig <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"phone-1\" value=\"\" placeholder=\"z.B. +493020054074\" id=\"forminator-field-phone-1_69e1b47b2b6a3\" class=\"forminator-input forminator-field--phone\" data-required=\"1\" aria-required=\"true\" autocomplete=\"off\" \/><\/div><\/div><div id=\"date-1\" class=\"forminator-field-date forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-date-1-picker_69e1b47b2b6a3\" id=\"forminator-field-date-1-picker_69e1b47b2b6a3-label\" class=\"forminator-label\">Geburtsdatum <span class=\"forminator-required\">*<\/span><\/label><div class=\"forminator-input-with-icon\"><span class=\"forminator-icon-calendar\" aria-hidden=\"true\"><\/span><input autocomplete=\"off\" type=\"text\" size=\"1\" name=\"date-1\" value=\"\" placeholder=\"\" id=\"forminator-field-date-1-picker_69e1b47b2b6a3\" class=\"forminator-input forminator-datepicker\" data-required=\"1\" data-format=\"dd.mm.yy\" data-restrict-type=\"\" data-restrict=\"\" data-start-year=\"1926\" data-end-year=\"2126\" data-past-dates=\"enable\" data-start-of-week=\"1\" data-start-date=\"\" data-end-date=\"\" data-start-field=\"\" data-end-field=\"\" data-start-offset=\"\" data-end-offset=\"\" data-disable-date=\"\" data-disable-range=\"\" \/><\/div><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"number-1\" class=\"forminator-field-number forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-number-1_69e1b47b2b6a3\" id=\"forminator-field-number-1_69e1b47b2b6a3-label\" class=\"forminator-label\">Gewicht in KG <span class=\"forminator-required\">*<\/span><\/label><input name=\"number-1\" value=\"\" placeholder=\"\" id=\"forminator-field-number-1_69e1b47b2b6a3\" class=\"forminator-input forminator-number--field\" inputmode=\"decimal\" data-required=\"1\" data-decimals=\"0\" aria-required=\"true\" data-inputmask=\"&#039;groupSeparator&#039;: &#039;&#039;, &#039;radixPoint&#039;: &#039;&#039;, &#039;digits&#039;: &#039;0&#039;\" data-hidden-behavior=\"zero\" type=\"number\" step=\"any\" min=\"1\" max=\"200\" \/><\/div><\/div><div id=\"select-1\" class=\"forminator-field-select forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-form-207__field--select-1_69e1b47b2b6a3\" id=\"forminator-form-207__field--select-1_69e1b47b2b6a3-label\" class=\"forminator-label\">Untersuchungsger\u00e4t <span class=\"forminator-required\">*<\/span><\/label><select  id=\"forminator-form-207__field--select-1_69e1b47b2b6a3\" class=\"forminator-select--field forminator-select2 forminator-select2-multiple\" data-required=\"1\" name=\"select-1\" data-default-value=\"\" data-hidden-behavior=\"zero\" data-placeholder=\"MRT\" data-search=\"false\" data-search-placeholder=\"MRT\" data-checkbox=\"false\" data-allow-clear=\"false\" aria-labelledby=\"forminator-form-207__field--select-1_69e1b47b2b6a3-label\"><option value=\"\"  >MRT<\/option><option value=\"one\"  data-calculation=\"0\">MRT<\/option><option value=\"two\"  data-calculation=\"0\">CT<\/option><\/select><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"select-4\" class=\"forminator-field-select forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-form-207__field--select-4_69e1b47b2b6a3\" id=\"forminator-form-207__field--select-4_69e1b47b2b6a3-label\" class=\"forminator-label\">Versicherung <span class=\"forminator-required\">*<\/span><\/label><select  id=\"forminator-form-207__field--select-4_69e1b47b2b6a3\" class=\"forminator-select--field forminator-select2 forminator-select2-multiple\" data-required=\"1\" name=\"select-4\" data-default-value=\"\" data-hidden-behavior=\"zero\" data-placeholder=\"Gesetzlich\" data-search=\"false\" data-search-placeholder=\"Gesetzlich\" data-checkbox=\"false\" data-allow-clear=\"false\" aria-labelledby=\"forminator-form-207__field--select-4_69e1b47b2b6a3-label\"><option value=\"\"  >Gesetzlich<\/option><option value=\"one\"  data-calculation=\"0\">Gesetzlich<\/option><option value=\"two\"  data-calculation=\"0\">BG<\/option><option value=\"Privat\"  data-calculation=\"0\">Privat<\/option><\/select><\/div><\/div><div id=\"select-3\" class=\"forminator-field-select forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-form-207__field--select-3_69e1b47b2b6a3\" id=\"forminator-form-207__field--select-3_69e1b47b2b6a3-label\" class=\"forminator-label\">Platzangst <span class=\"forminator-required\">*<\/span><\/label><select  id=\"forminator-form-207__field--select-3_69e1b47b2b6a3\" class=\"forminator-select--field forminator-select2 forminator-select2-multiple\" data-required=\"1\" name=\"select-3\" data-default-value=\"\" data-hidden-behavior=\"zero\" data-placeholder=\"Nein\" data-search=\"false\" data-search-placeholder=\"Nein\" data-checkbox=\"false\" data-allow-clear=\"false\" aria-labelledby=\"forminator-form-207__field--select-3_69e1b47b2b6a3-label\"><option value=\"\"  >Nein<\/option><option value=\"one\"  data-calculation=\"0\">Nein<\/option><option value=\"two\"  data-calculation=\"0\">Ja<\/option><\/select><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"textarea-2\" class=\"forminator-field-textarea forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-textarea-2_69e1b47b2b6a3\" id=\"forminator-field-textarea-2_69e1b47b2b6a3-label\" class=\"forminator-label\">Haben sie Metall im K\u00f6rper? <span class=\"forminator-required\">*<\/span><\/label><textarea name=\"textarea-2\" placeholder=\"\" id=\"forminator-field-textarea-2_69e1b47b2b6a3\" class=\"forminator-textarea\" rows=\"6\" style=\"min-height:140px;\" aria-describedby=\"forminator-field-textarea-2_69e1b47b2b6a3-description\" ><\/textarea><span id=\"forminator-field-textarea-2_69e1b47b2b6a3-description\" class=\"forminator-description\">Wenn Ja, wo und was.<\/span><\/div><\/div><div id=\"textarea-1\" class=\"forminator-field-textarea forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-textarea-1_69e1b47b2b6a3\" id=\"forminator-field-textarea-1_69e1b47b2b6a3-label\" class=\"forminator-label\">Welche Untersuchung? Region\/Organ\/Gelenk? Fragestellung? <span class=\"forminator-required\">*<\/span><\/label><textarea name=\"textarea-1\" placeholder=\"\" id=\"forminator-field-textarea-1_69e1b47b2b6a3\" class=\"forminator-textarea\" rows=\"6\" style=\"min-height:140px;\" maxlength=\"180\" ><\/textarea><span id=\"forminator-field-textarea-1_69e1b47b2b6a3-description\" class=\"forminator-description\"><span data-limit=\"180\" data-type=\"characters\" data-editor=\"\">0 \/ 180<\/span><\/span><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"upload-1\" class=\"forminator-field-upload forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-upload-1_69e1b47b2b6a3\" id=\"forminator-field-upload-1_69e1b47b2b6a3-label\" class=\"forminator-label\">\u00dcberweisungsschein (BITTE hochladen, danke!)<\/label><div class=\"forminator-file-upload \" data-element=\"upload-1_69e1b47b2b6a3\" aria-describedby=\"forminator-field-upload-1_69e1b47b2b6a3-description\"><input type=\"file\" name=\"upload-1\" id=\"forminator-field-upload-1_69e1b47b2b6a3\" class=\"forminator-input-file\" accept=\".jpg,.jpeg,.jpe,.gif,.png,.bmp,.tiff,.tif,.webp,.avif,.ico,.heic,.pdf,.psd,.xcf,.doc,.pot,.pps,.ppt,.wri,.mdb,.mpp,.docx,.docm,.dotx,.dotm,.onetoc,.onetoc2,.onetmp,.onepkg,.oxps,.xps,.odt,.odp,.odg,.odc,.odb,.odf,.wp,.wpd,.pages,.asf,.asx,.wmv,.wmx,.wm,.avi,.divx,.flv,.mov,.qt,.mpeg,.mpg,.mpe,.mp4,.m4v,.ogv,.webm,.mkv,.3gp,.3gpp,.3g2,.3gp2\" tabindex=\"-1\"><button id=\"forminator-field-upload-1_69e1b47b2b6a3_button\" class=\"forminator-button forminator-button-upload\" data-id=\"forminator-field-upload-1_69e1b47b2b6a3\">Datei ausw\u00e4hlen<\/button><span data-empty-text=\"Keine Datei ausgew\u00e4hlt\">Keine Datei ausgew\u00e4hlt<\/span><button class=\"forminator-button-delete\" style=\"display: none;\"><i class=\"forminator-icon-close\" aria-hidden=\"true\"><\/i><span class=\"forminator-screen-reader-only\">Hochgeladene Datei l\u00f6schen<\/span><\/button><\/div><span id=\"forminator-field-upload-1_69e1b47b2b6a3-description\" class=\"forminator-description\">Bevorzugt PDF-Dokumente<\/span><\/div><\/div><div id=\"consent-1\" class=\"forminator-field-consent forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-consent-1_69e1b47b2b6a3\" id=\"forminator-field-consent-1_69e1b47b2b6a3-label\" class=\"forminator-label\">Datenschutz <span class=\"forminator-required\">*<\/span><\/label><div class=\"forminator-checkbox__wrapper\"><label id=\"forminator-field-consent-1_69e1b47b2b6a3__label\" class=\"forminator-checkbox forminator-consent\"><input type=\"checkbox\" name=\"consent-1\" id=\"forminator-field-consent-1_69e1b47b2b6a3\" value=\"checked\" aria-labelledby=\"forminator-field-consent-1_69e1b47b2b6a3-label\" aria-describedby=\"forminator-field-consent-1_69e1b47b2b6a3__description\" data-required=\"true\" aria-required=\"true\" \/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><\/label><div id=\"forminator-field-consent-1_69e1b47b2b6a3__description\" class=\"forminator-checkbox__label forminator-consent__label\"><p>Ich akzeptiere die <a href=\"https:\/\/mrt-korves.de\/index.php\/datenschutzerklaerung\/\">Datenschutzerkl\u00e4rung<\/a>.<\/p><\/div><\/div><\/div><\/div><\/div><input type=\"hidden\" name=\"referer_url\" value=\"\" \/><div class=\"forminator-row forminator-row-last\"><div class=\"forminator-col\"><div class=\"forminator-field\"><button class=\"forminator-button forminator-button-submit float-right\">Abschicken<\/button><\/div><\/div><\/div><input type=\"hidden\" id=\"forminator_nonce\" name=\"forminator_nonce\" value=\"bfa1cd6f95\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/index.php\/wp-json\/wp\/v2\/pages\/208\" \/><input type=\"hidden\" name=\"form_id\" value=\"207\"><input type=\"hidden\" name=\"page_id\" value=\"208\"><input type=\"hidden\" name=\"form_type\" value=\"default\"><input type=\"hidden\" name=\"current_url\" value=\"https:\/\/mrt-korves.de\/index.php\/terminanfrage\/\"><input type=\"hidden\" name=\"render_id\" value=\"0\"><input type=\"hidden\" name=\"action\" value=\"forminator_submit_form_custom-forms\"><label for=\"input_13\" class=\"forminator-hidden\" aria-hidden=\"true\">Bitte f\u00fclle dieses Feld nicht aus. <input id=\"input_13\" type=\"text\" name=\"input_13\" value=\"\" autocomplete=\"off\"><\/label><\/form>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-208","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/mrt-korves.de\/index.php\/wp-json\/wp\/v2\/pages\/208","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/mrt-korves.de\/index.php\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/mrt-korves.de\/index.php\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/mrt-korves.de\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/mrt-korves.de\/index.php\/wp-json\/wp\/v2\/comments?post=208"}],"version-history":[{"count":0,"href":"https:\/\/mrt-korves.de\/index.php\/wp-json\/wp\/v2\/pages\/208\/revisions"}],"wp:attachment":[{"href":"https:\/\/mrt-korves.de\/index.php\/wp-json\/wp\/v2\/media?parent=208"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}