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	<title>Demo-App Archive - Physiotherapie Oberneuland</title>
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	<description>Das Therapiezentrum für Bremen und Umzu</description>
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	<title>Demo-App Archive - Physiotherapie Oberneuland</title>
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		<title>Anamnese &#8211; NEU</title>
		<link>https://physiotherapie-oberneuland.digiphysio.app/anamnese-neu/</link>
		
		<dc:creator><![CDATA[misterbk]]></dc:creator>
		<pubDate>Thu, 14 Nov 2024 17:27:07 +0000</pubDate>
				<guid isPermaLink="false">https://physiotherapie-oberneuland.digiphysio.app/?page_id=3485</guid>

					<description><![CDATA[<p>Der Beitrag <a href="https://physiotherapie-oberneuland.digiphysio.app/anamnese-neu/">Anamnese &#8211; NEU</a> erschien zuerst auf <a href="https://physiotherapie-oberneuland.digiphysio.app">Physiotherapie Oberneuland</a>.</p>
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										<content:encoded><![CDATA[<div class="wpb-content-wrapper"><div data-parent="true" class="vc_row row-container" id="row-unique-0"><div class="row no-top-padding single-bottom-padding no-h-padding limit-width row-parent"><div class="wpb_row row-inner"><div class="wpb_column pos-top pos-center align_left column_parent col-lg-12 single-internal-gutter"><div class="uncol style-light"  ><div class="uncoltable"><div class="uncell single-block-padding style-color-xsdn-bg has-bg unshadow-darker-std unradius-std" ><div class="uncont" ><div class="vc_row inverted-device-order row-internal row-container"><div class="row unequal col-no-gutter no-top-padding no-bottom-padding no-h-padding row-child"><div class="wpb_row row-inner"><div class="wpb_column pos-top pos-center align_left column_parent col-lg-12 no-internal-gutter"><div class="uncol style-light"  ><div class="uncoltable"><div class="uncell no-block-padding" ><div class="uncont" ><span class="btn-container" ><a role="button"  href="/basis/" class="custom-link btn btn-sm border-width-0 btn-color-138907 btn-flat btn-no-scale btn-icon-left" title="Demoapp Start"><i class="fa fa-arrow-back"></i>Zum Homebildschirm</a></span><div class="empty-space empty-single desktop-hidden" ><span class="empty-space-inner"></span></div>
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<div class="vc_custom_heading_wrap "><div class="heading-text el-text" ><h2 class="h2 text-color-138907-color" ><span>Anamneseformular &#8211; Draft</span></h2></div><div class="clear"></div></div><script>
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                        <div class='gform-body gform_body'><div id='gform_fields_30' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id="field_30_168" class="gfield gfield--type-honeypot gform_validation_container field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible"  ><label class='gfield_label gform-field-label' for='input_30_168'>Company</label><div class='ginput_container'><input name='input_168' id='input_30_168' type='text' value='' autocomplete='new-password'/></div><div class='gfield_description' id='gfield_description_30_168'>Dieses Feld dient zur Validierung und sollte nicht verändert werden.</div></div><div id="field_30_44" class="gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible"  ><h3 class="gsection_title">Herzlich Willkommen</h3><div class='gsection_description' id='gfield_description_30_44'>Sehr geehrte Patienten,<br>
<br>
unser Ziel ist es, Ihnen eine best&shy;mögliche Behandlung bieten zu können. Deshalb bitten wir Sie, diesen Frage&shy;bogen auszufüllen. <br>Vielen Dank!</div></div><div id="field_30_46" class="gfield gfield--type-section gfield--input-type-section gsection medifit field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"  ><h3 class="gsection_title">1. Basisdaten</h3></div><div id="field_30_47" class="gfield gfield--type-text gfield--input-type-text gfield--width-third gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"  ><label class='gfield_label gform-field-label' for='input_30_47'>Nachname<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_text'><input name='input_47' id='input_30_47' type='text' value='' class='large'     aria-required="true" aria-invalid="false"   /></div></div><div id="field_30_1" class="gfield gfield--type-text gfield--input-type-text gfield--width-third gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"  ><label class='gfield_label gform-field-label' for='input_30_1'>Vorname<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_text'><input name='input_1' id='input_30_1' type='text' value='' class='large'     aria-required="true" aria-invalid="false"   /></div></div><div id="field_30_55" class="gfield gfield--type-date gfield--input-type-date gfield--input-type-datepicker gfield--datepicker-default-icon gfield--width-third gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"  ><label class='gfield_label gform-field-label' for='input_30_55'>Geburtstag<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_date'>
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                            <input name='input_57' id='input_30_57' type='email' value='' class='large'   placeholder='info@physiotherapie-oberneuland.com' aria-required="true" aria-invalid="false"  />
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					<input class='gfield-choice-input' name='input_114' type='radio' value='10 (Maximaler Schmerz)'  id='choice_30_114_10' onchange='gformToggleRadioOther( this )'    />
					<label for='choice_30_114_10' id='label_30_114_10' class='gform-field-label gform-field-label--type-inline'>10 (Maximaler Schmerz)</label>
			</div></div></div></fieldset><fieldset id="field_30_115" class="gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible"  ><legend class='gfield_label gform-field-label' >2.3.2 Wie Stark sind Ihre Schmerzen maximal?<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></legend><div class='gfield_description' id='gfield_description_30_115'>Bitte Zutreffendes ankreuzen. Skala: (Kein Schmerz) 0 1 2 3 4 5 6 7 8 9 10 (maximaler Schmerz)</div><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_30_115'>
			<div class='gchoice gchoice_30_115_0'>
					<input class='gfield-choice-input' name='input_115' type='radio' value='0 (Kein Schmerz)'  id='choice_30_115_0' onchange='gformToggleRadioOther( this )' aria-describedby="gfield_description_30_115"   />
					<label for='choice_30_115_0' id='label_30_115_0' class='gform-field-label gform-field-label--type-inline'>0 (Kein Schmerz)</label>
			</div>
			<div class='gchoice gchoice_30_115_1'>
					<input class='gfield-choice-input' name='input_115' type='radio' value='1'  id='choice_30_115_1' onchange='gformToggleRadioOther( this )'    />
					<label for='choice_30_115_1' id='label_30_115_1' class='gform-field-label gform-field-label--type-inline'>1</label>
			</div>
			<div class='gchoice gchoice_30_115_2'>
					<input class='gfield-choice-input' name='input_115' type='radio' value='2'  id='choice_30_115_2' onchange='gformToggleRadioOther( this )'    />
					<label for='choice_30_115_2' id='label_30_115_2' class='gform-field-label gform-field-label--type-inline'>2</label>
			</div>
			<div class='gchoice gchoice_30_115_3'>
					<input class='gfield-choice-input' name='input_115' type='radio' value='3'  id='choice_30_115_3' onchange='gformToggleRadioOther( this )'    />
					<label for='choice_30_115_3' id='label_30_115_3' class='gform-field-label gform-field-label--type-inline'>3</label>
			</div>
			<div class='gchoice gchoice_30_115_4'>
					<input class='gfield-choice-input' name='input_115' type='radio' value='4'  id='choice_30_115_4' onchange='gformToggleRadioOther( this )'    />
					<label for='choice_30_115_4' id='label_30_115_4' class='gform-field-label gform-field-label--type-inline'>4</label>
			</div>
			<div class='gchoice gchoice_30_115_5'>
					<input class='gfield-choice-input' name='input_115' type='radio' value='5'  id='choice_30_115_5' onchange='gformToggleRadioOther( this )'    />
					<label for='choice_30_115_5' id='label_30_115_5' class='gform-field-label gform-field-label--type-inline'>5</label>
			</div>
			<div class='gchoice gchoice_30_115_6'>
					<input class='gfield-choice-input' name='input_115' type='radio' value='6'  id='choice_30_115_6' onchange='gformToggleRadioOther( this )'    />
					<label for='choice_30_115_6' id='label_30_115_6' class='gform-field-label gform-field-label--type-inline'>6</label>
			</div>
			<div class='gchoice gchoice_30_115_7'>
					<input class='gfield-choice-input' name='input_115' type='radio' value='7'  id='choice_30_115_7' onchange='gformToggleRadioOther( this )'    />
					<label for='choice_30_115_7' id='label_30_115_7' class='gform-field-label gform-field-label--type-inline'>7</label>
			</div>
			<div class='gchoice gchoice_30_115_8'>
					<input class='gfield-choice-input' name='input_115' type='radio' value='8'  id='choice_30_115_8' onchange='gformToggleRadioOther( this )'    />
					<label for='choice_30_115_8' id='label_30_115_8' class='gform-field-label gform-field-label--type-inline'>8</label>
			</div>
			<div class='gchoice gchoice_30_115_9'>
					<input class='gfield-choice-input' name='input_115' type='radio' value='9'  id='choice_30_115_9' onchange='gformToggleRadioOther( this )'    />
					<label for='choice_30_115_9' id='label_30_115_9' class='gform-field-label gform-field-label--type-inline'>9</label>
			</div>
			<div class='gchoice gchoice_30_115_10'>
					<input class='gfield-choice-input' name='input_115' type='radio' value='10 (Maximaler Schmerz)'  id='choice_30_115_10' onchange='gformToggleRadioOther( this )'    />
					<label for='choice_30_115_10' id='label_30_115_10' class='gform-field-label gform-field-label--type-inline'>10 (Maximaler Schmerz)</label>
			</div></div></div></fieldset><fieldset id="field_30_116" class="gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"  ><legend class='gfield_label gform-field-label' >2.4 Ist Ihre Beweglichkeit verändert?<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_30_116'>
			<div class='gchoice gchoice_30_116_0'>
					<input class='gfield-choice-input' name='input_116' type='radio' value='Ja'  id='choice_30_116_0' onchange='gformToggleRadioOther( this )'    />
					<label for='choice_30_116_0' id='label_30_116_0' class='gform-field-label gform-field-label--type-inline'>Ja</label>
			</div>
			<div class='gchoice gchoice_30_116_1'>
					<input class='gfield-choice-input' name='input_116' type='radio' value='Nein'  id='choice_30_116_1' onchange='gformToggleRadioOther( this )'    />
					<label for='choice_30_116_1' id='label_30_116_1' class='gform-field-label gform-field-label--type-inline'>Nein</label>
			</div></div></div></fieldset><div id="field_30_117" class="gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"  ><label class='gfield_label gform-field-label' for='input_30_117'>2.4.1 Ist Ihre Beweglichkeit verändert? Wenn ja, wo?<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_textarea'><textarea name='input_117' id='input_30_117' class='textarea small'     aria-required="true" aria-invalid="false"   rows='10' cols='50'></textarea></div></div><fieldset id="field_30_160" class="gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"  ><legend class='gfield_label gform-field-label' >2.5 Ist Ihre Sensibilität verändert (Haben Sie Kribbelerscheinungen / Taubheit)?<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_30_160'>
			<div class='gchoice gchoice_30_160_0'>
					<input class='gfield-choice-input' name='input_160' type='radio' value='Ja'  id='choice_30_160_0' onchange='gformToggleRadioOther( this )'    />
					<label for='choice_30_160_0' id='label_30_160_0' class='gform-field-label gform-field-label--type-inline'>Ja</label>
			</div>
			<div class='gchoice gchoice_30_160_1'>
					<input class='gfield-choice-input' name='input_160' type='radio' value='Nein'  id='choice_30_160_1' onchange='gformToggleRadioOther( this )'    />
					<label for='choice_30_160_1' id='label_30_160_1' class='gform-field-label gform-field-label--type-inline'>Nein</label>
			</div></div></div></fieldset><div id="field_30_119" class="gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"  ><label class='gfield_label gform-field-label' for='input_30_119'>2.5.1 Ist Ihre Sensibilität verändert (Haben Sie Kribbelerscheinungen / Taubheit)? Wenn ja, wo?<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_textarea'><textarea name='input_119' id='input_30_119' class='textarea small'     aria-required="true" aria-invalid="false"   rows='10' cols='50'></textarea></div></div><fieldset id="field_30_121" class="gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"  ><legend class='gfield_label gform-field-label' >2.6 Haben Sie einen Kraftverlust?<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_30_121'>
			<div class='gchoice gchoice_30_121_0'>
					<input class='gfield-choice-input' name='input_121' type='radio' value='Ja'  id='choice_30_121_0' onchange='gformToggleRadioOther( this )'    />
					<label for='choice_30_121_0' id='label_30_121_0' class='gform-field-label gform-field-label--type-inline'>Ja</label>
			</div>
			<div class='gchoice gchoice_30_121_1'>
					<input class='gfield-choice-input' name='input_121' type='radio' value='Nein'  id='choice_30_121_1' onchange='gformToggleRadioOther( this )'    />
					<label for='choice_30_121_1' id='label_30_121_1' class='gform-field-label gform-field-label--type-inline'>Nein</label>
			</div></div></div></fieldset><fieldset id="field_30_161" class="gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"  ><legend class='gfield_label gform-field-label' >2.7 Haben Sie im Alltag Einschränkungen (Beschwerden)?<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_30_161'>
			<div class='gchoice gchoice_30_161_0'>
					<input class='gfield-choice-input' name='input_161' type='radio' value='Ja'  id='choice_30_161_0' onchange='gformToggleRadioOther( this )'    />
					<label for='choice_30_161_0' id='label_30_161_0' class='gform-field-label gform-field-label--type-inline'>Ja</label>
			</div>
			<div class='gchoice gchoice_30_161_1'>
					<input class='gfield-choice-input' name='input_161' type='radio' value='Nein'  id='choice_30_161_1' onchange='gformToggleRadioOther( this )'    />
					<label for='choice_30_161_1' id='label_30_161_1' class='gform-field-label gform-field-label--type-inline'>Nein</label>
			</div></div></div></fieldset><div id="field_30_122" class="gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"  ><label class='gfield_label gform-field-label' for='input_30_122'>2.7.1 Haben Sie im Alltag Einschränkungen (Beschwerden)? Wenn ja, welche?<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_textarea'><textarea name='input_122' id='input_30_122' class='textarea small'     aria-required="true" aria-invalid="false"   rows='10' cols='50'></textarea></div></div><div id="field_30_123" class="gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"  ><label class='gfield_label gform-field-label' for='input_30_123'>2.8 Wie lange haben Sie Ihre Beschwerden schon?<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_textarea'><textarea name='input_123' id='input_30_123' class='textarea small'     aria-required="true" aria-invalid="false"   rows='10' cols='50'></textarea></div></div><fieldset id="field_30_162" class="gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"  ><legend class='gfield_label gform-field-label' >2.9 Gab es einen Auslöser für Ihre Beschwerden?<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_30_162'>
			<div class='gchoice gchoice_30_162_0'>
					<input class='gfield-choice-input' name='input_162' type='radio' value='Ja'  id='choice_30_162_0' onchange='gformToggleRadioOther( this )'    />
					<label for='choice_30_162_0' id='label_30_162_0' class='gform-field-label gform-field-label--type-inline'>Ja</label>
			</div>
			<div class='gchoice gchoice_30_162_1'>
					<input class='gfield-choice-input' name='input_162' type='radio' value='Nein'  id='choice_30_162_1' onchange='gformToggleRadioOther( this )'    />
					<label for='choice_30_162_1' id='label_30_162_1' class='gform-field-label gform-field-label--type-inline'>Nein</label>
			</div></div></div></fieldset><div id="field_30_124" class="gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible"  ><label class='gfield_label gform-field-label' for='input_30_124'>2.9.1 Gab es einen Auslöser für Ihre Beschwerden? Wenn ja, welche?<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='gfield_description' id='gfield_description_30_124'>(Z.B.: Sturz, Unfall, Psychisch, Persönlich, Stress, etc.)</div><div class='ginput_container ginput_container_textarea'><textarea name='input_124' id='input_30_124' class='textarea small'  aria-describedby="gfield_description_30_124"   aria-required="true" aria-invalid="false"   rows='10' cols='50'></textarea></div></div><fieldset id="field_30_164" class="gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"  ><legend class='gfield_label gform-field-label' >2.10 Hatten Sie in Ihrem Leben schon Unfälle, Narben und / oder Operationen?<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_30_164'>
			<div class='gchoice gchoice_30_164_0'>
					<input class='gfield-choice-input' name='input_164' type='radio' value='Ja'  id='choice_30_164_0' onchange='gformToggleRadioOther( this )'    />
					<label for='choice_30_164_0' id='label_30_164_0' class='gform-field-label gform-field-label--type-inline'>Ja</label>
			</div>
			<div class='gchoice gchoice_30_164_1'>
					<input class='gfield-choice-input' name='input_164' type='radio' value='Nein'  id='choice_30_164_1' onchange='gformToggleRadioOther( this )'    />
					<label for='choice_30_164_1' id='label_30_164_1' class='gform-field-label gform-field-label--type-inline'>Nein</label>
			</div></div></div></fieldset><div id="field_30_125" class="gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible"  ><label class='gfield_label gform-field-label' for='input_30_125'>2.10.1 Hatten Sie in Ihrem Leben schon Unfälle, Narben und / oder Operationen? Wenn ja, wann und wo?<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_textarea'><textarea name='input_125' id='input_30_125' class='textarea small'     aria-required="true" aria-invalid="false"   rows='10' cols='50'></textarea></div></div><fieldset id="field_30_165" class="gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"  ><legend class='gfield_label gform-field-label' >2.11 Gibt es eine Position / Aktivität, die Ihre Beschwerden kurzzeitig verbessert?<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_30_165'>
			<div class='gchoice gchoice_30_165_0'>
					<input class='gfield-choice-input' name='input_165' type='radio' value='Ja'  id='choice_30_165_0' onchange='gformToggleRadioOther( this )'    />
					<label for='choice_30_165_0' id='label_30_165_0' class='gform-field-label gform-field-label--type-inline'>Ja</label>
			</div>
			<div class='gchoice gchoice_30_165_1'>
					<input class='gfield-choice-input' name='input_165' type='radio' value='Nein'  id='choice_30_165_1' onchange='gformToggleRadioOther( this )'    />
					<label for='choice_30_165_1' id='label_30_165_1' class='gform-field-label gform-field-label--type-inline'>Nein</label>
			</div></div></div></fieldset><div id="field_30_126" class="gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible"  ><label class='gfield_label gform-field-label' for='input_30_126'>2.11.1 Gibt es eine Position / Aktivität, die Ihre Beschwerden kurzzeitig verbessert? Wenn ja, mit welchen?<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='gfield_description' id='gfield_description_30_126'>(z.B. Aktivität, Bewegung, Ruhe, Stehen, Sitzen, Liegen, Gehen, Tragen, Tageszeit, etc.)</div><div class='ginput_container ginput_container_textarea'><textarea name='input_126' id='input_30_126' class='textarea small'  aria-describedby="gfield_description_30_126"   aria-required="true" aria-invalid="false"   rows='10' cols='50'></textarea></div></div><fieldset id="field_30_166" class="gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"  ><legend class='gfield_label gform-field-label' >2.12 Gibt es eine Position / Aktivität, die Ihre Beschwerden kurzzeitig verschlechtert?<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_30_166'>
			<div class='gchoice gchoice_30_166_0'>
					<input class='gfield-choice-input' name='input_166' type='radio' value='Ja'  id='choice_30_166_0' onchange='gformToggleRadioOther( this )'    />
					<label for='choice_30_166_0' id='label_30_166_0' class='gform-field-label gform-field-label--type-inline'>Ja</label>
			</div>
			<div class='gchoice gchoice_30_166_1'>
					<input class='gfield-choice-input' name='input_166' type='radio' value='Nein'  id='choice_30_166_1' onchange='gformToggleRadioOther( this )'    />
					<label for='choice_30_166_1' id='label_30_166_1' class='gform-field-label gform-field-label--type-inline'>Nein</label>
			</div></div></div></fieldset><div id="field_30_127" class="gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible"  ><label class='gfield_label gform-field-label' for='input_30_127'>2.12.1 Gibt es eine Position / Aktivität, die Ihre Beschwerden kurzzeitig verschlechtert? Wenn ja, bei welchen?<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='gfield_description' id='gfield_description_30_127'>(z.B. Aktivität, Bewegung, Ruhe, Stehen, Sitzen, Liegen, Gehen, Tragen, Tageszeit, etc.)</div><div class='ginput_container ginput_container_textarea'><textarea name='input_127' id='input_30_127' class='textarea small'  aria-describedby="gfield_description_30_127"   aria-required="true" aria-invalid="false"   rows='10' cols='50'></textarea></div></div><fieldset id="field_30_128" class="gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible"  ><legend class='gfield_label gform-field-label' >2.13 Haben Sie Ihre Beschwerden Permanent / mit Unterbrechungen?<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></legend><div class='gfield_description' id='gfield_description_30_128'>Zutreffendes bitte ankreuzen</div><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_30_128'>
			<div class='gchoice gchoice_30_128_0'>
					<input class='gfield-choice-input' name='input_128' type='radio' value='Permanent'  id='choice_30_128_0' onchange='gformToggleRadioOther( this )' aria-describedby="gfield_description_30_128"   />
					<label for='choice_30_128_0' id='label_30_128_0' class='gform-field-label gform-field-label--type-inline'>Permanent</label>
			</div>
			<div class='gchoice gchoice_30_128_1'>
					<input class='gfield-choice-input' name='input_128' type='radio' value='mit Unterbrechungen'  id='choice_30_128_1' onchange='gformToggleRadioOther( this )'    />
					<label for='choice_30_128_1' id='label_30_128_1' class='gform-field-label gform-field-label--type-inline'>mit Unterbrechungen</label>
			</div></div></div></fieldset><fieldset id="field_30_130" class="gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible"  ><legend class='gfield_label gform-field-label' >2.14 Beschreiben Sie Ihre Beschwerden:<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></legend><div class='gfield_description' id='gfield_description_30_130'>Zutreffendes bitte ankreuzen</div><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_30_130'>
			<div class='gchoice gchoice_30_130_0'>
					<input class='gfield-choice-input' name='input_130' type='radio' value='gleich bleibend'  id='choice_30_130_0' onchange='gformToggleRadioOther( this )' aria-describedby="gfield_description_30_130"   />
					<label for='choice_30_130_0' id='label_30_130_0' class='gform-field-label gform-field-label--type-inline'>gleich bleibend</label>
			</div>
			<div class='gchoice gchoice_30_130_1'>
					<input class='gfield-choice-input' name='input_130' type='radio' value='besser werdend'  id='choice_30_130_1' onchange='gformToggleRadioOther( this )'    />
					<label for='choice_30_130_1' id='label_30_130_1' class='gform-field-label gform-field-label--type-inline'>besser werdend</label>
			</div>
			<div class='gchoice gchoice_30_130_2'>
					<input class='gfield-choice-input' name='input_130' type='radio' value='verschlechternd'  id='choice_30_130_2' onchange='gformToggleRadioOther( this )'    />
					<label for='choice_30_130_2' id='label_30_130_2' class='gform-field-label gform-field-label--type-inline'>verschlechternd</label>
			</div></div></div></fieldset><fieldset id="field_30_131" class="gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >2.15 Haben Sie Schmerzen beim:<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></legend><div class='gfield_description' id='gfield_description_30_131'>Mehrfachantworten sind möglich. Bitte Zutreffendes ankreuzen</div><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_30_131'><div class='gchoice gchoice_30_131_1'>
								<input class='gfield-choice-input' name='input_131.1' type='checkbox'  value='Husten'  id='choice_30_131_1'   aria-describedby="gfield_description_30_131"/>
								<label for='choice_30_131_1' id='label_30_131_1' class='gform-field-label gform-field-label--type-inline'>Husten</label>
							</div><div class='gchoice gchoice_30_131_2'>
								<input class='gfield-choice-input' name='input_131.2' type='checkbox'  value='Niesen'  id='choice_30_131_2'   />
								<label for='choice_30_131_2' id='label_30_131_2' class='gform-field-label gform-field-label--type-inline'>Niesen</label>
							</div><div class='gchoice gchoice_30_131_3'>
								<input class='gfield-choice-input' name='input_131.3' type='checkbox'  value='Pressen'  id='choice_30_131_3'   />
								<label for='choice_30_131_3' id='label_30_131_3' class='gform-field-label gform-field-label--type-inline'>Pressen</label>
							</div><div class='gchoice gchoice_30_131_4'>
								<input class='gfield-choice-input' name='input_131.4' type='checkbox'  value='Schlucken'  id='choice_30_131_4'   />
								<label for='choice_30_131_4' id='label_30_131_4' class='gform-field-label gform-field-label--type-inline'>Schlucken</label>
							</div></div></div></fieldset><fieldset id="field_30_132" class="gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible"  ><legend class='gfield_label gform-field-label' >2.16 Haben Sie Gang-, oder Gleichgewichtsstörungen?<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></legend><div class='gfield_description' id='gfield_description_30_132'>Zutreffendes bitte ankreuzen</div><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_30_132'>
			<div class='gchoice gchoice_30_132_0'>
					<input class='gfield-choice-input' name='input_132' type='radio' value='Ja'  id='choice_30_132_0' onchange='gformToggleRadioOther( this )' aria-describedby="gfield_description_30_132"   />
					<label for='choice_30_132_0' id='label_30_132_0' class='gform-field-label gform-field-label--type-inline'>Ja</label>
			</div>
			<div class='gchoice gchoice_30_132_1'>
					<input class='gfield-choice-input' name='input_132' type='radio' value='Nein'  id='choice_30_132_1' onchange='gformToggleRadioOther( this )'    />
					<label for='choice_30_132_1' id='label_30_132_1' class='gform-field-label gform-field-label--type-inline'>Nein</label>
			</div></div></div></fieldset><fieldset id="field_30_133" class="gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible"  ><legend class='gfield_label gform-field-label' >2.17 Sind Sie schwanger?<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></legend><div class='gfield_description' id='gfield_description_30_133'>Zutreffendes bitte ankreuzen</div><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_30_133'>
			<div class='gchoice gchoice_30_133_0'>
					<input class='gfield-choice-input' name='input_133' type='radio' value='Ja'  id='choice_30_133_0' onchange='gformToggleRadioOther( this )' aria-describedby="gfield_description_30_133"   />
					<label for='choice_30_133_0' id='label_30_133_0' class='gform-field-label gform-field-label--type-inline'>Ja</label>
			</div>
			<div class='gchoice gchoice_30_133_1'>
					<input class='gfield-choice-input' name='input_133' type='radio' value='Nein'  id='choice_30_133_1' onchange='gformToggleRadioOther( this )'    />
					<label for='choice_30_133_1' id='label_30_133_1' class='gform-field-label gform-field-label--type-inline'>Nein</label>
			</div></div></div></fieldset><fieldset id="field_30_134" class="gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible"  ><legend class='gfield_label gform-field-label' >2.18 Hatten Sie in der Vergangenheit Geburten?<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></legend><div class='gfield_description' id='gfield_description_30_134'>Zutreffendes bitte ankreuzen</div><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_30_134'>
			<div class='gchoice gchoice_30_134_0'>
					<input class='gfield-choice-input' name='input_134' type='radio' value='Ja'  id='choice_30_134_0' onchange='gformToggleRadioOther( this )' aria-describedby="gfield_description_30_134"   />
					<label for='choice_30_134_0' id='label_30_134_0' class='gform-field-label gform-field-label--type-inline'>Ja</label>
			</div>
			<div class='gchoice gchoice_30_134_1'>
					<input class='gfield-choice-input' name='input_134' type='radio' value='Nein'  id='choice_30_134_1' onchange='gformToggleRadioOther( this )'    />
					<label for='choice_30_134_1' id='label_30_134_1' class='gform-field-label gform-field-label--type-inline'>Nein</label>
			</div></div></div></fieldset><div id="field_30_135" class="gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"  ><label class='gfield_label gform-field-label' for='input_30_135'>2.18.1 Wann? Spontan oder Kaiserschnitt?<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_text'><input name='input_135' id='input_30_135' type='text' value='' class='large'     aria-required="true" aria-invalid="false"   /></div></div><fieldset id="field_30_136" class="gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible"  ><legend class='gfield_label gform-field-label' >2.19 Leiden Sie unter Schwindel, Übelkeit, Kopfschmerzen, Ohnmachtsanfällen oder Schluckstörungen?<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></legend><div class='gfield_description' id='gfield_description_30_136'>Zutreffendes bitte ankreuzen</div><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_30_136'>
			<div class='gchoice gchoice_30_136_0'>
					<input class='gfield-choice-input' name='input_136' type='radio' value='Ja'  id='choice_30_136_0' onchange='gformToggleRadioOther( this )' aria-describedby="gfield_description_30_136"   />
					<label for='choice_30_136_0' id='label_30_136_0' class='gform-field-label gform-field-label--type-inline'>Ja</label>
			</div>
			<div class='gchoice gchoice_30_136_1'>
					<input class='gfield-choice-input' name='input_136' type='radio' value='Nein'  id='choice_30_136_1' onchange='gformToggleRadioOther( this )'    />
					<label for='choice_30_136_1' id='label_30_136_1' class='gform-field-label gform-field-label--type-inline'>Nein</label>
			</div></div></div></fieldset><fieldset id="field_30_139" class="gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >2.19.1 Welche der o. g. Leiden haben Sie?<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_30_139'><div class='gchoice gchoice_30_139_1'>
								<input class='gfield-choice-input' name='input_139.1' type='checkbox'  value='Schwindel'  id='choice_30_139_1'   />
								<label for='choice_30_139_1' id='label_30_139_1' class='gform-field-label gform-field-label--type-inline'>Schwindel</label>
							</div><div class='gchoice gchoice_30_139_2'>
								<input class='gfield-choice-input' name='input_139.2' type='checkbox'  value='Übelkeit'  id='choice_30_139_2'   />
								<label for='choice_30_139_2' id='label_30_139_2' class='gform-field-label gform-field-label--type-inline'>Übelkeit</label>
							</div><div class='gchoice gchoice_30_139_3'>
								<input class='gfield-choice-input' name='input_139.3' type='checkbox'  value='Kopfschmerzen'  id='choice_30_139_3'   />
								<label for='choice_30_139_3' id='label_30_139_3' class='gform-field-label gform-field-label--type-inline'>Kopfschmerzen</label>
							</div><div class='gchoice gchoice_30_139_4'>
								<input class='gfield-choice-input' name='input_139.4' type='checkbox'  value='Ohnmachtsanfällen'  id='choice_30_139_4'   />
								<label for='choice_30_139_4' id='label_30_139_4' class='gform-field-label gform-field-label--type-inline'>Ohnmachtsanfällen</label>
							</div><div class='gchoice gchoice_30_139_5'>
								<input class='gfield-choice-input' name='input_139.5' type='checkbox'  value='Schluckstörungen'  id='choice_30_139_5'   />
								<label for='choice_30_139_5' id='label_30_139_5' class='gform-field-label gform-field-label--type-inline'>Schluckstörungen</label>
							</div></div></div></fieldset><fieldset id="field_30_137" class="gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible"  ><legend class='gfield_label gform-field-label' >2.20 Haben Sie eine der folgenden Erkrankungen: Diabetes, Rheuma, Osteoporose?<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></legend><div class='gfield_description' id='gfield_description_30_137'>Zutreffendes bitte ankreuzen</div><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_30_137'>
			<div class='gchoice gchoice_30_137_0'>
					<input class='gfield-choice-input' name='input_137' type='radio' value='Ja'  id='choice_30_137_0' onchange='gformToggleRadioOther( this )' aria-describedby="gfield_description_30_137"   />
					<label for='choice_30_137_0' id='label_30_137_0' class='gform-field-label gform-field-label--type-inline'>Ja</label>
			</div>
			<div class='gchoice gchoice_30_137_1'>
					<input class='gfield-choice-input' name='input_137' type='radio' value='Nein'  id='choice_30_137_1' onchange='gformToggleRadioOther( this )'    />
					<label for='choice_30_137_1' id='label_30_137_1' class='gform-field-label gform-field-label--type-inline'>Nein</label>
			</div></div></div></fieldset><fieldset id="field_30_167" class="gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >2.20.1 Welche der o. g. Erkrankungen haben Sie?<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_30_167'><div class='gchoice gchoice_30_167_1'>
								<input class='gfield-choice-input' name='input_167.1' type='checkbox'  value='Diabetes'  id='choice_30_167_1'   />
								<label for='choice_30_167_1' id='label_30_167_1' class='gform-field-label gform-field-label--type-inline'>Diabetes</label>
							</div><div class='gchoice gchoice_30_167_2'>
								<input class='gfield-choice-input' name='input_167.2' type='checkbox'  value='Rheuma'  id='choice_30_167_2'   />
								<label for='choice_30_167_2' id='label_30_167_2' class='gform-field-label gform-field-label--type-inline'>Rheuma</label>
							</div><div class='gchoice gchoice_30_167_3'>
								<input class='gfield-choice-input' name='input_167.3' type='checkbox'  value='Osteoporose'  id='choice_30_167_3'   />
								<label for='choice_30_167_3' id='label_30_167_3' class='gform-field-label gform-field-label--type-inline'>Osteoporose</label>
							</div></div></div></fieldset><fieldset id="field_30_141" class="gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >2.21 Haben Sie Probleme mit den inneren Organen (Sodbrennen, Verstopfungen, etc.)?<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_30_141'><div class='gchoice gchoice_30_141_1'>
								<input class='gfield-choice-input' name='input_141.1' type='checkbox'  value='Sodbrennen'  id='choice_30_141_1'   />
								<label for='choice_30_141_1' id='label_30_141_1' class='gform-field-label gform-field-label--type-inline'>Sodbrennen</label>
							</div><div class='gchoice gchoice_30_141_2'>
								<input class='gfield-choice-input' name='input_141.2' type='checkbox'  value='Verstopfungen'  id='choice_30_141_2'   />
								<label for='choice_30_141_2' id='label_30_141_2' class='gform-field-label gform-field-label--type-inline'>Verstopfungen</label>
							</div><div class='gchoice gchoice_30_141_3'>
								<input class='gfield-choice-input' name='input_141.3' type='checkbox'  value='keine'  id='choice_30_141_3'   />
								<label for='choice_30_141_3' id='label_30_141_3' class='gform-field-label gform-field-label--type-inline'>keine</label>
							</div><div class='gchoice gchoice_30_141_4'>
								<input class='gfield-choice-input' name='input_141.4' type='checkbox'  value='Andere Probleme mit inneren Organen'  id='choice_30_141_4'   />
								<label for='choice_30_141_4' id='label_30_141_4' class='gform-field-label gform-field-label--type-inline'>Andere Probleme mit inneren Organen</label>
							</div></div></div></fieldset><div id="field_30_142" class="gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"  ><label class='gfield_label gform-field-label' for='input_30_142'>2.21.1 Welche anderen Probleme mit den inneren Organen haben Sie?<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_text'><input name='input_142' id='input_30_142' type='text' value='' class='large'     aria-required="true" aria-invalid="false"   /></div></div><fieldset id="field_30_143" class="gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible"  ><legend class='gfield_label gform-field-label' >2.22 Haben Sie weitere Erkrankungen (z.B. Bluthochdruck, Fieber, Unwohlsein, Blutgerinnungsstörung, Schilddrüsenüber-, unterfunktion, HIV.)?<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></legend><div class='gfield_description' id='gfield_description_30_143'>Zutreffendes bitte ankreuzen</div><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_30_143'>
			<div class='gchoice gchoice_30_143_0'>
					<input class='gfield-choice-input' name='input_143' type='radio' value='Ja'  id='choice_30_143_0' onchange='gformToggleRadioOther( this )' aria-describedby="gfield_description_30_143"   />
					<label for='choice_30_143_0' id='label_30_143_0' class='gform-field-label gform-field-label--type-inline'>Ja</label>
			</div>
			<div class='gchoice gchoice_30_143_1'>
					<input class='gfield-choice-input' name='input_143' type='radio' value='Nein'  id='choice_30_143_1' onchange='gformToggleRadioOther( this )'    />
					<label for='choice_30_143_1' id='label_30_143_1' class='gform-field-label gform-field-label--type-inline'>Nein</label>
			</div></div></div></fieldset><div id="field_30_144" class="gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"  ><label class='gfield_label gform-field-label' for='input_30_144'>2.22.1 Wenn ja, welche weiteren Erkrankungen haben Sie?<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_text'><input name='input_144' id='input_30_144' type='text' value='' class='large'     aria-required="true" aria-invalid="false"   /></div></div><fieldset id="field_30_145" class="gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible"  ><legend class='gfield_label gform-field-label' >2.23 Nehmen Sie momentan Medikamente / Hormone ein?<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></legend><div class='gfield_description' id='gfield_description_30_145'>Zutreffendes bitte ankreuzen</div><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_30_145'>
			<div class='gchoice gchoice_30_145_0'>
					<input class='gfield-choice-input' name='input_145' type='radio' value='Ja'  id='choice_30_145_0' onchange='gformToggleRadioOther( this )' aria-describedby="gfield_description_30_145"   />
					<label for='choice_30_145_0' id='label_30_145_0' class='gform-field-label gform-field-label--type-inline'>Ja</label>
			</div>
			<div class='gchoice gchoice_30_145_1'>
					<input class='gfield-choice-input' name='input_145' type='radio' value='Nein'  id='choice_30_145_1' onchange='gformToggleRadioOther( this )'    />
					<label for='choice_30_145_1' id='label_30_145_1' class='gform-field-label gform-field-label--type-inline'>Nein</label>
			</div></div></div></fieldset><div id="field_30_146" class="gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"  ><label class='gfield_label gform-field-label' for='input_30_146'>2.23.1 Wenn ja, welche Medikamente / Hormone nehmen Sie ein?<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_text'><input name='input_146' id='input_30_146' type='text' value='' class='large'     aria-required="true" aria-invalid="false"   /></div></div><fieldset id="field_30_147" class="gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible"  ><legend class='gfield_label gform-field-label' >2.24 Hatten Sie jemals einen Tumor, oder eine Krebserkrankung?<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></legend><div class='gfield_description' id='gfield_description_30_147'>Zutreffendes bitte ankreuzen</div><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_30_147'>
			<div class='gchoice gchoice_30_147_0'>
					<input class='gfield-choice-input' name='input_147' type='radio' value='Ja'  id='choice_30_147_0' onchange='gformToggleRadioOther( this )' aria-describedby="gfield_description_30_147"   />
					<label for='choice_30_147_0' id='label_30_147_0' class='gform-field-label gform-field-label--type-inline'>Ja</label>
			</div>
			<div class='gchoice gchoice_30_147_1'>
					<input class='gfield-choice-input' name='input_147' type='radio' value='Nein'  id='choice_30_147_1' onchange='gformToggleRadioOther( this )'    />
					<label for='choice_30_147_1' id='label_30_147_1' class='gform-field-label gform-field-label--type-inline'>Nein</label>
			</div></div></div></fieldset><fieldset id="field_30_148" class="gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible"  ><legend class='gfield_label gform-field-label' >2.25 Haben Sie nachts Schmerzen?<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></legend><div class='gfield_description' id='gfield_description_30_148'>Zutreffendes bitte ankreuzen</div><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_30_148'>
			<div class='gchoice gchoice_30_148_0'>
					<input class='gfield-choice-input' name='input_148' type='radio' value='Ja'  id='choice_30_148_0' onchange='gformToggleRadioOther( this )' aria-describedby="gfield_description_30_148"   />
					<label for='choice_30_148_0' id='label_30_148_0' class='gform-field-label gform-field-label--type-inline'>Ja</label>
			</div>
			<div class='gchoice gchoice_30_148_1'>
					<input class='gfield-choice-input' name='input_148' type='radio' value='Nein'  id='choice_30_148_1' onchange='gformToggleRadioOther( this )'    />
					<label for='choice_30_148_1' id='label_30_148_1' class='gform-field-label gform-field-label--type-inline'>Nein</label>
			</div></div></div></fieldset><fieldset id="field_30_149" class="gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible"  ><legend class='gfield_label gform-field-label' >2.26 Hatten Sie in den vergangenen Wochen unerwartet abgenommen, nächtliches Schwitzen, Abgeschlagenheit?<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></legend><div class='gfield_description' id='gfield_description_30_149'>Zutreffendes bitte ankreuzen</div><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_30_149'>
			<div class='gchoice gchoice_30_149_0'>
					<input class='gfield-choice-input' name='input_149' type='radio' value='Ja'  id='choice_30_149_0' onchange='gformToggleRadioOther( this )' aria-describedby="gfield_description_30_149"   />
					<label for='choice_30_149_0' id='label_30_149_0' class='gform-field-label gform-field-label--type-inline'>Ja</label>
			</div>
			<div class='gchoice gchoice_30_149_1'>
					<input class='gfield-choice-input' name='input_149' type='radio' value='Nein'  id='choice_30_149_1' onchange='gformToggleRadioOther( this )'    />
					<label for='choice_30_149_1' id='label_30_149_1' class='gform-field-label gform-field-label--type-inline'>Nein</label>
			</div></div></div></fieldset><fieldset id="field_30_150" class="gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible"  ><legend class='gfield_label gform-field-label' >2.27 Hatten Sie in der vergangenen Woche Fieber?<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></legend><div class='gfield_description' id='gfield_description_30_150'>Zutreffendes bitte ankreuzen</div><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_30_150'>
			<div class='gchoice gchoice_30_150_0'>
					<input class='gfield-choice-input' name='input_150' type='radio' value='Ja'  id='choice_30_150_0' onchange='gformToggleRadioOther( this )' aria-describedby="gfield_description_30_150"   />
					<label for='choice_30_150_0' id='label_30_150_0' class='gform-field-label gform-field-label--type-inline'>Ja</label>
			</div>
			<div class='gchoice gchoice_30_150_1'>
					<input class='gfield-choice-input' name='input_150' type='radio' value='Nein'  id='choice_30_150_1' onchange='gformToggleRadioOther( this )'    />
					<label for='choice_30_150_1' id='label_30_150_1' class='gform-field-label gform-field-label--type-inline'>Nein</label>
			</div></div></div></fieldset><fieldset id="field_30_151" class="gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible"  ><legend class='gfield_label gform-field-label' >2.28 Leiden Sie unter häufigen Infekten (mehr als 5 Infekte pro Jahr)?<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></legend><div class='gfield_description' id='gfield_description_30_151'>Zutreffendes bitte ankreuzen</div><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_30_151'>
			<div class='gchoice gchoice_30_151_0'>
					<input class='gfield-choice-input' name='input_151' type='radio' value='Ja'  id='choice_30_151_0' onchange='gformToggleRadioOther( this )' aria-describedby="gfield_description_30_151"   />
					<label for='choice_30_151_0' id='label_30_151_0' class='gform-field-label gform-field-label--type-inline'>Ja</label>
			</div>
			<div class='gchoice gchoice_30_151_1'>
					<input class='gfield-choice-input' name='input_151' type='radio' value='Nein'  id='choice_30_151_1' onchange='gformToggleRadioOther( this )'    />
					<label for='choice_30_151_1' id='label_30_151_1' class='gform-field-label gform-field-label--type-inline'>Nein</label>
			</div></div></div></fieldset><fieldset id="field_30_152" class="gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible"  ><legend class='gfield_label gform-field-label' >2.29 Fühlen Sie sich psychisch belastet und / oder gestresst?<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></legend><div class='gfield_description' id='gfield_description_30_152'>Zutreffendes bitte ankreuzen</div><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_30_152'>
			<div class='gchoice gchoice_30_152_0'>
					<input class='gfield-choice-input' name='input_152' type='radio' value='Ja'  id='choice_30_152_0' onchange='gformToggleRadioOther( this )' aria-describedby="gfield_description_30_152"   />
					<label for='choice_30_152_0' id='label_30_152_0' class='gform-field-label gform-field-label--type-inline'>Ja</label>
			</div>
			<div class='gchoice gchoice_30_152_1'>
					<input class='gfield-choice-input' name='input_152' type='radio' value='Nein'  id='choice_30_152_1' onchange='gformToggleRadioOther( this )'    />
					<label for='choice_30_152_1' id='label_30_152_1' class='gform-field-label gform-field-label--type-inline'>Nein</label>
			</div></div></div></fieldset><fieldset id="field_30_153" class="gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible"  ><legend class='gfield_label gform-field-label' >2.30 Ist ihr Schlaf ausreichend / erholsam?<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></legend><div class='gfield_description' id='gfield_description_30_153'>Zutreffendes bitte ankreuzen</div><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_30_153'>
			<div class='gchoice gchoice_30_153_0'>
					<input class='gfield-choice-input' name='input_153' type='radio' value='Ja'  id='choice_30_153_0' onchange='gformToggleRadioOther( this )' aria-describedby="gfield_description_30_153"   />
					<label for='choice_30_153_0' id='label_30_153_0' class='gform-field-label gform-field-label--type-inline'>Ja</label>
			</div>
			<div class='gchoice gchoice_30_153_1'>
					<input class='gfield-choice-input' name='input_153' type='radio' value='Nein'  id='choice_30_153_1' onchange='gformToggleRadioOther( this )'    />
					<label for='choice_30_153_1' id='label_30_153_1' class='gform-field-label gform-field-label--type-inline'>Nein</label>
			</div></div></div></fieldset><fieldset id="field_30_154" class="gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible"  ><legend class='gfield_label gform-field-label' >2.31 Haben Sie sonstige Beschwerden, welche mit den Hauptbeschwerden nicht im Zusammenhang stehen ( Seh-, Sprech-, Hörprobleme, Inkontinenz, Hilfsmittel, etc) ?<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></legend><div class='gfield_description' id='gfield_description_30_154'>Zutreffendes bitte ankreuzen</div><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_30_154'>
			<div class='gchoice gchoice_30_154_0'>
					<input class='gfield-choice-input' name='input_154' type='radio' value='Ja'  id='choice_30_154_0' onchange='gformToggleRadioOther( this )' aria-describedby="gfield_description_30_154"   />
					<label for='choice_30_154_0' id='label_30_154_0' class='gform-field-label gform-field-label--type-inline'>Ja</label>
			</div>
			<div class='gchoice gchoice_30_154_1'>
					<input class='gfield-choice-input' name='input_154' type='radio' value='Nein'  id='choice_30_154_1' onchange='gformToggleRadioOther( this )'    />
					<label for='choice_30_154_1' id='label_30_154_1' class='gform-field-label gform-field-label--type-inline'>Nein</label>
			</div></div></div></fieldset><div id="field_30_155" class="gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"  ><label class='gfield_label gform-field-label' for='input_30_155'>2.31.1 Wenn ja, welche sonstigen Beschwerden haben Sie, die nicht im Zusammenhang mit den Hauptbeschwerden stehen?<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_text'><input name='input_155' id='input_30_155' type='text' value='' class='large'     aria-required="true" aria-invalid="false"   /></div></div><fieldset id="field_30_156" class="gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible"  ><legend class='gfield_label gform-field-label' >2.32 Welche Maßnahmen zur Diagnostik / Therapie wurden bisher durchgeführt?<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></legend><div class='gfield_description' id='gfield_description_30_156'>Zutreffendes bitte ankreuzen</div><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_30_156'>
			<div class='gchoice gchoice_30_156_0'>
					<input class='gfield-choice-input' name='input_156' type='radio' value='Keine'  id='choice_30_156_0' onchange='gformToggleRadioOther( this )' aria-describedby="gfield_description_30_156"   />
					<label for='choice_30_156_0' id='label_30_156_0' class='gform-field-label gform-field-label--type-inline'>Keine</label>
			</div>
			<div class='gchoice gchoice_30_156_1'>
					<input class='gfield-choice-input' name='input_156' type='radio' value='Welche:'  id='choice_30_156_1' onchange='gformToggleRadioOther( this )'    />
					<label for='choice_30_156_1' id='label_30_156_1' class='gform-field-label gform-field-label--type-inline'>Welche:</label>
			</div></div></div></fieldset><fieldset id="field_30_157" class="gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >2.32 Welche Maßnahmen zur Diagnostik / Therapie waren das?<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_30_157'><div class='gchoice gchoice_30_157_1'>
								<input class='gfield-choice-input' name='input_157.1' type='checkbox'  value='Röntgen'  id='choice_30_157_1'   />
								<label for='choice_30_157_1' id='label_30_157_1' class='gform-field-label gform-field-label--type-inline'>Röntgen</label>
							</div><div class='gchoice gchoice_30_157_2'>
								<input class='gfield-choice-input' name='input_157.2' type='checkbox'  value='Computertomographie'  id='choice_30_157_2'   />
								<label for='choice_30_157_2' id='label_30_157_2' class='gform-field-label gform-field-label--type-inline'>Computertomographie</label>
							</div><div class='gchoice gchoice_30_157_3'>
								<input class='gfield-choice-input' name='input_157.3' type='checkbox'  value='Kernspintographie (MRT)'  id='choice_30_157_3'   />
								<label for='choice_30_157_3' id='label_30_157_3' class='gform-field-label gform-field-label--type-inline'>Kernspintographie (MRT)</label>
							</div><div class='gchoice gchoice_30_157_4'>
								<input class='gfield-choice-input' name='input_157.4' type='checkbox'  value='Spritze'  id='choice_30_157_4'   />
								<label for='choice_30_157_4' id='label_30_157_4' class='gform-field-label gform-field-label--type-inline'>Spritze</label>
							</div><div class='gchoice gchoice_30_157_5'>
								<input class='gfield-choice-input' name='input_157.5' type='checkbox'  value='Massage'  id='choice_30_157_5'   />
								<label for='choice_30_157_5' id='label_30_157_5' class='gform-field-label gform-field-label--type-inline'>Massage</label>
							</div><div class='gchoice gchoice_30_157_6'>
								<input class='gfield-choice-input' name='input_157.6' type='checkbox'  value='Physiotherapie'  id='choice_30_157_6'   />
								<label for='choice_30_157_6' id='label_30_157_6' class='gform-field-label gform-field-label--type-inline'>Physiotherapie</label>
							</div><div class='gchoice gchoice_30_157_7'>
								<input class='gfield-choice-input' name='input_157.7' type='checkbox'  value='Blutbild'  id='choice_30_157_7'   />
								<label for='choice_30_157_7' id='label_30_157_7' class='gform-field-label gform-field-label--type-inline'>Blutbild</label>
							</div><div class='gchoice gchoice_30_157_8'>
								<input class='gfield-choice-input' name='input_157.8' type='checkbox'  value='Andere Maßnahmen'  id='choice_30_157_8'   />
								<label for='choice_30_157_8' id='label_30_157_8' class='gform-field-label gform-field-label--type-inline'>Andere Maßnahmen</label>
							</div></div></div></fieldset><div id="field_30_158" class="gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"  ><label class='gfield_label gform-field-label' for='input_30_158'>2.32.1 Wenn ja, welche anderen Maßnahmen wurden bisher durchgeführt?<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_text'><input name='input_158' id='input_30_158' type='text' value='' class='large'     aria-required="true" aria-invalid="false"   /></div></div><div id="field_30_110" class="gfield gfield--type-fileupload gfield--input-type-fileupload gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible"  ><label class='gfield_label gform-field-label' for='gform_browse_button_30_110'>2.32.2 Upload Unterlagen<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='gfield_description' id='gfield_description_30_110'>(z.B. Überweisung, Arztbericht, OP-Bericht, etc.)</div><div class='ginput_container ginput_container_fileupload'><div id='gform_multifile_upload_30_110' data-settings='{&quot;runtimes&quot;:&quot;html5,flash,html4&quot;,&quot;browse_button&quot;:&quot;gform_browse_button_30_110&quot;,&quot;container&quot;:&quot;gform_multifile_upload_30_110&quot;,&quot;drop_element&quot;:&quot;gform_drag_drop_area_30_110&quot;,&quot;filelist&quot;:&quot;gform_preview_30_110&quot;,&quot;unique_names&quot;:true,&quot;file_data_name&quot;:&quot;file&quot;,&quot;url&quot;:&quot;https:\/\/physiotherapie-oberneuland.digiphysio.app\/?gf_page=2a80c7404f24eaf&quot;,&quot;flash_swf_url&quot;:&quot;https:\/\/physiotherapie-oberneuland.digiphysio.app\/wp-includes\/js\/plupload\/plupload.flash.swf&quot;,&quot;silverlight_xap_url&quot;:&quot;https:\/\/physiotherapie-oberneuland.digiphysio.app\/wp-includes\/js\/plupload\/plupload.silverlight.xap&quot;,&quot;filters&quot;:{&quot;mime_types&quot;:[{&quot;title&quot;:&quot;Erlaubte Dateitypen&quot;,&quot;extensions&quot;:&quot;jpeg,jpg,png,pdf&quot;}],&quot;max_file_size&quot;:&quot;10485760b&quot;},&quot;multipart&quot;:true,&quot;urlstream_upload&quot;:false,&quot;multipart_params&quot;:{&quot;form_id&quot;:30,&quot;field_id&quot;:110,&quot;_gform_file_upload_nonce_30_110&quot;:&quot;df54894e6f&quot;},&quot;gf_vars&quot;:{&quot;max_files&quot;:&quot;10&quot;,&quot;message_id&quot;:&quot;gform_multifile_messages_30_110&quot;,&quot;disallowed_extensions&quot;:[&quot;php&quot;,&quot;asp&quot;,&quot;aspx&quot;,&quot;cmd&quot;,&quot;csh&quot;,&quot;bat&quot;,&quot;html&quot;,&quot;htm&quot;,&quot;hta&quot;,&quot;jar&quot;,&quot;exe&quot;,&quot;com&quot;,&quot;js&quot;,&quot;lnk&quot;,&quot;htaccess&quot;,&quot;phar&quot;,&quot;phtml&quot;,&quot;ps1&quot;,&quot;ps2&quot;,&quot;php3&quot;,&quot;php4&quot;,&quot;php5&quot;,&quot;php6&quot;,&quot;py&quot;,&quot;rb&quot;,&quot;tmp&quot;]}}' class='gform_fileupload_multifile'>
										<div id='gform_drag_drop_area_30_110' class='gform_drop_area gform-theme-field-control'>
											<span class='gform_drop_instructions'>Ziehe Dateien hier her oder </span>
											<button type='button' id='gform_browse_button_30_110' class='button gform_button_select_files gform-theme-button gform-theme-button--control' aria-describedby="gfield_upload_rules_30_110 gfield_description_30_110"  >Wähle Dateien aus</button>
										</div>
									</div><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_30_110'>Akzeptierte Dateitypen: jpeg, jpg, png, pdf, Max. Dateigröße: 10 MB, Max. Dateien: 10.</span><ul class='validation_message--hidden-on-empty gform-ul-reset' id='gform_multifile_messages_30_110'></ul> <div id='gform_preview_30_110' class='ginput_preview_list'></div></div></div><div id="field_30_159" class="gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"  ><label class='gfield_label gform-field-label' for='input_30_159'>2.33 Was sind Ihre Erwartungen und Ziele für die Therapie:</label><div class='ginput_container ginput_container_textarea'><textarea name='input_159' id='input_30_159' class='textarea small'      aria-invalid="false"   rows='10' cols='50'></textarea></div></div><div id="field_30_45" class="gfield gfield--type-section gfield--input-type-section gsection medifit field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"  ><h3 class="gsection_title">3. Schlussbestimmungen</h3></div><fieldset id="field_30_93" class="gfield gfield--type-consent gfield--type-choice gfield--input-type-consent gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Ausfallgebühr / Terminabsage<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></legend><div class='ginput_container ginput_container_consent'><input name='input_93.1' id='input_30_93_1' type='checkbox' value='1'  aria-describedby="gfield_consent_description_30_93" aria-required="true" aria-invalid="false"   /> <label class="gform-field-label gform-field-label--type-inline gfield_consent_label" for='input_30_93_1' >Hiermit bestätige ich die Kenntnisnahme des vorliegenden Sachverhaltes.</label><input type='hidden' name='input_93.2' value='Hiermit bestätige ich die Kenntnisnahme des vorliegenden Sachverhaltes.' class='gform_hidden' /><input type='hidden' name='input_93.3' value='70' class='gform_hidden' /></div><div class='gfield_description gfield_consent_description' id='gfield_consent_description_30_93' tabindex='0'>Vereinbarte Behandlungstermine sind <b>spätestens 24 Stunden vorher</b> abzusagen. Für kurzfristig abgesagte oder versäumte Termine müssen wir Ihnen die Kosten für den uns dadurch entstandenen Schaden privat in Rechnung stellen!</div></fieldset><fieldset id="field_30_108" class="gfield gfield--type-consent gfield--type-choice gfield--input-type-consent gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Datenschutzerklärung<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></legend><div class='ginput_container ginput_container_consent'><input name='input_108.1' id='input_30_108_1' type='checkbox' value='1'  aria-describedby="gfield_consent_description_30_108" aria-required="true" aria-invalid="false"   /> <label class="gform-field-label gform-field-label--type-inline gfield_consent_label" for='input_30_108_1' >Hiermit bestätige ich die Kenntnisnahme der vorliegenden Datenschutzerklärung.</label><input type='hidden' name='input_108.2' value='Hiermit bestätige ich die Kenntnisnahme der vorliegenden Datenschutzerklärung.' class='gform_hidden' /><input type='hidden' name='input_108.3' value='70' class='gform_hidden' /></div><div class='gfield_description gfield_consent_description' id='gfield_consent_description_30_108' tabindex='0'>Ich bin einverstanden, dass durch die Praxis Physiotherapie Oberneuland GbR und/oder Physio FIT GbR Kühtmann & Brandt, Mühlenfeldstraße 33c, 28355 Bremen meine Daten zu folgenden Zwecken erhoben, verarbeitet und genutzt werden: Zur Pflege der Kontaktdaten, der Erfüllung des Behandlungsvertrags, zur Abrechnung erbrachter Leistungen mit Krankenkassen, Abrechnungsstellen oder dem Patienten, zur therapeutischen Dokumentation, zum Erstellen von Behandlungsberichten und Arztbriefen sowie zur Abrechnung erbrachter Leistungen. Zu diesen Zwecken können Ihre Daten an den überweisenden Arzt, die Krankenkasse und/oder die Abrechnungsstelle weitergegeben oder werden. Dort werden diese ebenfalls zu folgenden Zwecken verarbeitet und genutzt: Zur Pflege der Kontaktdaten, zur Abrechnung erbrachter Leistungen mit Krankenkassen, zur therapeutischen Dokumentation. Ich bin darauf hingewiesen worden, dass die im Rahmen der vorstehenden genannten Zweck erhobenen persönlichen Daten meiner Person unter Beachtung des DSGVO und des BDSG erhoben, verarbeitet, genutzt und übermittelt werden. Die Erhebung, Verarbeitung und Nutzung meiner Daten auf freiwilliger Basis erfolgt und dass ich mein Einverständnis verweigern mit der Folge, dass der Behandlungsvertrag nicht erfüllt werden kann/nicht zustande kommt und die Behandlung mit der Krankenkasse nicht abgerechnet werden kann. Ich bin jederzeit berechtigt, Auskunft über die zu meiner Person gespeicherten Daten zu verlangen.<br />
Ich bin jederzeit berechtigt, die Berichtigung, Löschung oder Sperrung einzelner Personen bezogener Daten zu verlangen. Ich bin jederzeit berechtigt, mit Wirkung für die Zukunft diese Einwilligungserklärung zu widerrufen.<br />
Im Falle des Widerrufs, ist der Widerruf zu richten an:<br />
Praxis:<br />
Physiotherapie Oberneuland GbR Kühtmann & Brandt<br />
Mühlenfeldstr 33c<br />
28355 Bremen<br />
0421 33004970<br />
info@physiotherapie-oberneuland.com<br />
Im Falle des Widerrufs werden meine Daten nach Ablauf gesetzlicher Fristen und falls solche nicht mehr zu beachten sind, mit dem Zugang der Willenserklärung der Praxis gelöscht. Die Praxis wird meinen Widerruf an die o. g. Dritten weiterleiten, die ihrerseits dann meine Daten löschen.</div></fieldset><div id="field_30_94" class="gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"  ><label class='gfield_label gform-field-label' for='input_30_94'>Ort<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_text'><input name='input_94' id='input_30_94' type='text' value='' class='large'     aria-required="true" aria-invalid="false"   /></div></div><div id="field_30_95" class="gfield gfield--type-date gfield--input-type-date gfield--input-type-datepicker gfield--datepicker-default-icon gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"  ><label class='gfield_label gform-field-label' for='input_30_95'>Datum<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_date'>
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</div><p>Der Beitrag <a href="https://physiotherapie-oberneuland.digiphysio.app/anamnese-neu/">Anamnese &#8211; NEU</a> erschien zuerst auf <a href="https://physiotherapie-oberneuland.digiphysio.app">Physiotherapie Oberneuland</a>.</p>
]]></content:encoded>
					
		
		
			</item>
		<item>
		<title>App-Daten löschen</title>
		<link>https://physiotherapie-oberneuland.digiphysio.app/app-daten-loeschen/</link>
		
		<dc:creator><![CDATA[misterbk]]></dc:creator>
		<pubDate>Mon, 10 Jun 2024 18:03:14 +0000</pubDate>
				<guid isPermaLink="false">https://physiotherapie-oberneuland.digiphysio.app/?page_id=3449</guid>

					<description><![CDATA[<p>Der Beitrag <a href="https://physiotherapie-oberneuland.digiphysio.app/app-daten-loeschen/">App-Daten löschen</a> erschien zuerst auf <a href="https://physiotherapie-oberneuland.digiphysio.app">Physiotherapie Oberneuland</a>.</p>
]]></description>
										<content:encoded><![CDATA[<div class="wpb-content-wrapper"><div data-parent="true" class="vc_row row-container" id="row-unique-1"><div class="row no-top-padding single-bottom-padding no-h-padding limit-width row-parent"><div class="wpb_row row-inner"><div class="wpb_column pos-top pos-center align_left column_parent col-lg-12 single-internal-gutter"><div class="uncol style-light"  ><div class="uncoltable"><div class="uncell single-block-padding style-color-xsdn-bg has-bg unshadow-darker-std unradius-std" ><div class="uncont" ><div class="vc_row inverted-device-order row-internal row-container"><div class="row unequal col-no-gutter no-top-padding no-bottom-padding no-h-padding row-child"><div class="wpb_row row-inner"><div class="wpb_column pos-top pos-center align_left column_parent col-lg-12 no-internal-gutter"><div class="uncol style-light"  ><div class="uncoltable"><div class="uncell no-block-padding" ><div class="uncont" ><span class="btn-container" ><a role="button"  href="/basis/" class="custom-link btn btn-sm border-width-0 btn-color-138907 btn-flat btn-no-scale btn-icon-left" title="Demoapp Start"><i class="fa fa-arrow-back"></i>Zum Homebildschirm</a></span><div class="empty-space empty-single desktop-hidden" ><span class="empty-space-inner"></span></div>
</div></div></div></div></div></div></div></div>
<div class="vc_custom_heading_wrap "><div class="heading-text el-text" ><h2 class="h3 text-color-138907-color" ><span>Ihr Antrag auf Löschung personenbezogener Daten nach Art. 17 DSGVO</span></h2></div><div class="clear"></div></div>
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                        <div class='gform_heading'>
							<p class='gform_required_legend'>„<span class="gfield_required gfield_required_asterisk">*</span>“ zeigt erforderliche Felder an</p>
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                        <div class='gform-body gform_body'><div id='gform_fields_28' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id="field_28_122" class="gfield gfield--type-honeypot gform_validation_container field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible"  ><label class='gfield_label gform-field-label' for='input_28_122'>X/Twitter</label><div class='ginput_container'><input name='input_122' id='input_28_122' type='text' value='' autocomplete='new-password'/></div><div class='gfield_description' id='gfield_description_28_122'>Dieses Feld dient zur Validierung und sollte nicht verändert werden.</div></div><div id="field_28_44" class="gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible"  ><h3 class="gsection_title">Aufforderung</h3><div class='gsection_description' id='gfield_description_28_44'>Sehr geehrte Praxis,<br>
<br>
hiermit übe ich mein Widerspruchsrecht zur Löschung meiner personenbezogenen Daten aus.<br>
Aus Datenschutzgründen, gemäß der EU-Datenschutz-Grundverordnung, haben Sie das Recht, die Entfernung bestimmter personenbezogener Daten zu beantragen.
<br>
<b>Ich stelle hiermit Antrag auf unverzügliche Löschung mich betreffender personenbezogener Daten gemäß Art. 17 Abs. 1 DSGVO.
Bitte löschen Sie sämtliche mich betreffenden personenbezogenen Daten nach der Definition des Art. 4 Nr. 1 DSGVO.</b></div></div><div id="field_28_46" class="gfield gfield--type-section gfield--input-type-section gsection medifit field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible"  ><h3 class="gsection_title">1. Meine Angaben</h3><div class='gsection_description' id='gfield_description_28_46'><b>Vollständiger Name</b><br>
Auch wenn der Antrag im Namen einer anderen Person gestellt wird, zu deren Vertretung Sie autorisiert sind. Um einen Antrag für eine andere Person einzureichen, benötigen Sie eine entsprechende rechtliche Autorisierung. <br>
<br>
Ich bin der Meinung, dass die Voraussetzungen des Art. 17 Abs. 1 DSGVO gegeben sind. Sie können auch keinen Ausnahmetatbestand nach Art. 17 Abs. 3 DSGVO geltend machen, zumal ich keine Person des öffentlichen Lebens bin.
<br>
Sollte ich eine Einwilligung zur Verarbeitung meiner Daten erteilt haben, widerrufe ich diese hiermit für den gesamten Prozess der Datenverarbeitung.</div></div><div id="field_28_47" class="gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"  ><label class='gfield_label gform-field-label' for='input_28_47'>Nachname<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_text'><input name='input_47' id='input_28_47' type='text' value='' class='large'     aria-required="true" aria-invalid="false"   /></div></div><div id="field_28_1" class="gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"  ><label class='gfield_label gform-field-label' for='input_28_1'>Vorname<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_text'><input name='input_1' id='input_28_1' type='text' value='' class='large'     aria-required="true" aria-invalid="false"   /></div></div><div id="field_28_57" class="gfield gfield--type-email gfield--input-type-email gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"  ><label class='gfield_label gform-field-label' for='input_28_57'>Kontakt-Email-Adresse<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_email'>
                            <input name='input_57' id='input_28_57' type='email' value='' class='large'   placeholder='info@physiotherapie-oberneuland.com' aria-required="true" aria-invalid="false"  />
                        </div></div><div id="field_28_53" class="gfield gfield--type-phone gfield--input-type-phone gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"  ><label class='gfield_label gform-field-label' for='input_28_53'>Telefonnummer<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_phone'><input name='input_53' id='input_28_53' type='tel' value='' class='large'  placeholder='(0421) 33 00 49 70' aria-required="true" aria-invalid="false"   /></div></div><fieldset id="field_28_111" class="gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible"  ><legend class='gfield_label gform-field-label' >Ich handle im Namen von...<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_28_111'>
			<div class='gchoice gchoice_28_111_0'>
					<input class='gfield-choice-input' name='input_111' type='radio' value='Mich selbst'  id='choice_28_111_0' onchange='gformToggleRadioOther( this )' aria-describedby="gfield_description_28_111"   />
					<label for='choice_28_111_0' id='label_28_111_0' class='gform-field-label gform-field-label--type-inline'>Mich selbst</label>
			</div>
			<div class='gchoice gchoice_28_111_1'>
					<input class='gfield-choice-input' name='input_111' type='radio' value='Einen Kunden'  id='choice_28_111_1' onchange='gformToggleRadioOther( this )'    />
					<label for='choice_28_111_1' id='label_28_111_1' class='gform-field-label gform-field-label--type-inline'>Einen Kunden</label>
			</div>
			<div class='gchoice gchoice_28_111_2'>
					<input class='gfield-choice-input' name='input_111' type='radio' value='Ein Familienmitglied'  id='choice_28_111_2' onchange='gformToggleRadioOther( this )'    />
					<label for='choice_28_111_2' id='label_28_111_2' class='gform-field-label gform-field-label--type-inline'>Ein Familienmitglied</label>
			</div>
			<div class='gchoice gchoice_28_111_3'>
					<input class='gfield-choice-input' name='input_111' type='radio' value='Einen Freund'  id='choice_28_111_3' onchange='gformToggleRadioOther( this )'    />
					<label for='choice_28_111_3' id='label_28_111_3' class='gform-field-label gform-field-label--type-inline'>Einen Freund</label>
			</div>
			<div class='gchoice gchoice_28_111_4'>
					<input class='gfield-choice-input' name='input_111' type='radio' value='gf_other_choice'  id='choice_28_111_4' onchange='gformToggleRadioOther( this )'    />
					<label for='choice_28_111_4' id='label_28_111_4' class='gform-field-label gform-field-label--type-inline'>Anderes</label><br /><input id='input_28_111_other' class='gchoice_other_control' name='input_111_other' type='text' value='Anderes' aria-label='Andere Wahl, bitte angeben'  disabled='disabled' />
			</div></div></div><div class='gfield_description' id='gfield_description_28_111'>Falls Sie den Antrag im Namen einer anderen Person einreichen, geben Sie bitte an, in welcher Beziehung Sie zu dieser Person stehen, zum Beispiel „Elternteil“ oder „Rechtsanwalt“. Wir fordern Sie möglicherweise auf nachzuweisen, dass Sie autorisiert sind, diese Person zu vertreten.</div></fieldset><fieldset id="field_28_112" class="gfield gfield--type-consent gfield--type-choice gfield--input-type-consent gfield--width-full field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Bereits gestellter Antrag</legend><div class='ginput_container ginput_container_consent'><input name='input_112.1' id='input_28_112_1' type='checkbox' value='1'  aria-describedby="gfield_consent_description_28_112"  aria-invalid="false"   /> <label class="gform-field-label gform-field-label--type-inline gfield_consent_label" for='input_28_112_1' >Ja, es wurden bereits Anträge gestellt.</label><input type='hidden' name='input_112.2' value='Ja, es wurden bereits Anträge gestellt.' class='gform_hidden' /><input type='hidden' name='input_112.3' value='68' class='gform_hidden' /></div><div class='gfield_description gfield_consent_description' id='gfield_consent_description_28_112' tabindex='0'>Falls Sie oder die betroffene Person bereits zuvor um die Entfernung ähnlicher Inhalte gebeten haben, können wir Ihnen schneller weiterhelfen, wenn Sie uns keine neue Nachricht senden, sondern stattdessen auf die E-Mail antworten, die wir Ihnen bzw. der betroffenen Person gesendet haben.</div></fieldset><div id="field_28_43" class="gfield gfield--type-section gfield--input-type-section gsection medifit field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible"  ><h3 class="gsection_title">2. Zu entfernende personenbezogene Daten</h3><div class='gsection_description' id='gfield_description_28_43'>Bitte erläutern Sie den Entfernungsgrund</div></div><div id="field_28_114" class="gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible"  ><label class='gfield_label gform-field-label' for='input_28_114'>Entfernungsgrund<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='gfield_description' id='gfield_description_28_114'>Bitte Entfernungsgrund erläutern. <br>
Warum sollten diese personenbezogenen Daten Ihrer Meinung nach aus der App entfernt werden?</div><div class='ginput_container ginput_container_textarea'><textarea name='input_114' id='input_28_114' class='textarea small'  aria-describedby="gfield_description_28_114"   aria-required="true" aria-invalid="false"   rows='10' cols='50'></textarea></div></div><div id="field_28_45" class="gfield gfield--type-section gfield--input-type-section gsection medifit field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible"  ><h3 class="gsection_title">3. Eidesstattliche Erklärungen</h3><div class='gsection_description' id='gfield_description_28_45'>Bitte lesen Sie die folgenden Erklärungen und bestätigen Sie mit einem Häkchen, dass Sie die Bestimmungen gelesen haben und akzeptieren.</div></div><fieldset id="field_28_93" class="gfield gfield--type-consent gfield--type-choice gfield--input-type-consent gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Erklärung zur Verarbeitung der von mir eingereichten personenbezogenen Daten<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></legend><div class='ginput_container ginput_container_consent'><input name='input_93.1' id='input_28_93_1' type='checkbox' value='1'  aria-describedby="gfield_consent_description_28_93" aria-required="true" aria-invalid="false"   /> <label class="gform-field-label gform-field-label--type-inline gfield_consent_label" for='input_28_93_1' >Ich habe die folgende Erklärung zur Verarbeitung der von mir eingereichten personenbezogenen Daten gelesen und akzeptiere sie:</label><input type='hidden' name='input_93.2' value='Ich habe die folgende Erklärung zur Verarbeitung der von mir eingereichten personenbezogenen Daten gelesen und akzeptiere sie:' class='gform_hidden' /><input type='hidden' name='input_93.3' value='68' class='gform_hidden' /></div><div class='gfield_description gfield_consent_description' id='gfield_consent_description_28_93' tabindex='0'>Die von Ihnen in diesem Formular sowie möglicherweise im Laufe der weiteren Korrespondenz angegebenen personenbezogenen Daten werden ausschließlich zum Zweck der Verarbeitung Ihres Antrags und zur Erfüllung seiner rechtlichen Verpflichtungen verwendet. Daten in diesem Sinne sind auch die E-Mail-Adresse und die Angaben und Belege zur Identität von Personen. Möglicherweise geben wir Einzelheiten Ihres Antrags an eine Datenschutzaufsichtsbehörde weiter. Wir tun dies jedoch nur, wenn diese die Daten von uns zu dem Zweck anfordern, eine von uns getroffene Entscheidung zu untersuchen oder zu überprüfen. Das passiert normalerweise dann, wenn Sie sich bezüglich unserer Entscheidung an Ihre nationale Datenschutzaufsichtsbehörde gewandt haben.</div></fieldset><fieldset id="field_28_117" class="gfield gfield--type-consent gfield--type-choice gfield--input-type-consent gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Widerspruch gegen die Verarbeitung mich betreffender personenbezogener Daten<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></legend><div class='ginput_container ginput_container_consent'><input name='input_117.1' id='input_28_117_1' type='checkbox' value='1'  aria-describedby="gfield_consent_description_28_117" aria-required="true" aria-invalid="false"   /> <label class="gform-field-label gform-field-label--type-inline gfield_consent_label" for='input_28_117_1' >Weiterhin lege ich im Sinne des Art. 21 Abs. 1 DSGVO Widerspruch gegen die Verarbeitung mich betreffender personenbezogener Daten ein, dies gilt auch für Profiling.</label><input type='hidden' name='input_117.2' value='Weiterhin lege ich im Sinne des Art. 21 Abs. 1 DSGVO Widerspruch gegen die Verarbeitung mich betreffender personenbezogener Daten ein, dies gilt auch für Profiling.' class='gform_hidden' /><input type='hidden' name='input_117.3' value='68' class='gform_hidden' /></div><div class='gfield_description gfield_consent_description' id='gfield_consent_description_28_117' tabindex='0'>Ich fordere Sie auf, die Verarbeitung der mich betreffenden Daten gemäß Art. 18 Abs. 1 lit. d DSGVO einzuschränken, solange noch nicht feststeht, ob Ihre berechtigten Gründe gegenüber meinen überwiegen.<br><br />
Falls Sie die betroffenen Daten öffentlich gemacht haben sollten, sind Sie nach Art. 17 Abs. 2 DSGVO dazu verpflichtet, alle angemessenen Maßnahmen zu treffen, um andere Verantwortliche, beispielsweise Suchmaschinenbetreiber, welche die oben aufgeführten personenbezogenen Daten verarbeiten, über meinen Antrag auf Löschung aller Links, Kopien oder Replikationen zu informieren. Dies gilt nicht nur für exakte Kopien der betroffenen Daten, sondern auch für solche, aus denen in den betroffenen Daten enthaltene Informationen entnehmbar sind.<br><br />
Sofern Sie die betroffenen personenbezogenen Daten einem oder mehreren Empfängern im Sinne des Art. 4 Nr. 9 DSGVO offengelegt haben, haben Sie meinen Wunsch auf Löschung der genannten personenbezogenen Daten und sämtlicher Verweise darauf nach Art. 19 DSGVO auch allen solchen Empfängern mitzuteilen. Bitte informieren Sie mich weiterhin über diese Empfänger.<br><br />
<b>Sollten Sie die Löschung ablehnen, haben Sie dies mir gegenüber zu begründen.</b></div></fieldset><fieldset id="field_28_118" class="gfield gfield--type-consent gfield--type-choice gfield--input-type-consent gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Widerspruch gegen weitere Angebote und Unternehmen<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></legend><div class='ginput_container ginput_container_consent'><input name='input_118.1' id='input_28_118_1' type='checkbox' value='1'  aria-describedby="gfield_consent_description_28_118" aria-required="true" aria-invalid="false"   /> <label class="gform-field-label gform-field-label--type-inline gfield_consent_label" for='input_28_118_1' >Hiermit lege ich Widerspruch ein</label><input type='hidden' name='input_118.2' value='Hiermit lege ich Widerspruch ein' class='gform_hidden' /><input type='hidden' name='input_118.3' value='68' class='gform_hidden' /></div><div class='gfield_description gfield_consent_description' id='gfield_consent_description_28_118' tabindex='0'>Meine Anfrage schließt explizit auch sämtliche weiteren Angebote und Unternehmen ein, für die Sie Verantwortlicher im Sinne des Art. 4 Nr. 7 DSGVO sind.</div></fieldset><div id="field_28_121" class="gfield gfield--type-section gfield--input-type-section gsection medifit field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible"  ><h3 class="gsection_title">4. Aufforderung Fristeinhaltung</h3><div class='gsection_description' id='gfield_description_28_121'>Nach Art. 12 Abs. 3 DSGVO haben Sie mich unverzüglich, spätestens aber innerhalb eines Monats nach Eingang des Antrags, über die vorgenommenen Löschungen zu informieren.<br>
<b>Sollten Sie meinem Antrag nicht innerhalb der genannten Frist nachkommen, behalte ich mir vor rechtliche Schritte gegen Sie einzuleiten und Beschwerde bei der zuständigen Datenschutzaufsichtsbehörde einzureichen.</b></div></div><div id="field_28_94" class="gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"  ><label class='gfield_label gform-field-label' for='input_28_94'>Ort<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_text'><input name='input_94' id='input_28_94' type='text' value='' class='large'     aria-required="true" aria-invalid="false"   /></div></div><div id="field_28_95" class="gfield gfield--type-date gfield--input-type-date gfield--input-type-datepicker gfield--datepicker-default-icon gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"  ><label class='gfield_label gform-field-label' for='input_28_95'>Datum<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_date'>
                            <input name='input_95' id='input_28_95' type='text' value='' class='datepicker gform-datepicker dmy_dot datepicker_with_icon gdatepicker_with_icon'   placeholder='tt.mm.jjjj' aria-describedby="input_28_95_date_format" aria-invalid="false" aria-required="true"/>
                            <span id='input_28_95_date_format' class='screen-reader-text'>TT Punkt MM Punkt JJJJ</span>
                        </div>
                        <input type='hidden' id='gforms_calendar_icon_input_28_95' class='gform_hidden' value='https://physiotherapie-oberneuland.digiphysio.app/wp-content/plugins/gravityforms/images/datepicker/datepicker.svg'/></div><div id="field_28_97" class="gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden"  ><script type="text/javascript">
gform.addFilter( 'gform_datepicker_options_pre_init', function( optionsObj, formId, fieldId ) {
if ( formId == 28 && fieldId == 95 ) {
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</script></div><div id="field_28_96" class="gfield gfield--type-signature gfield--input-type-signature gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible"  ><label class='gfield_label gform-field-label' for='input_28_96'>Mit freundlichen Grüßen<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='gfield_description' id='gfield_description_28_96'>Bitte identifizieren Sie sich mit Ihrer Unterschrift.</div><input type='hidden' value='' name='input_96' id='input_28_96_signature_filename'/><div class='gfield_signature_ui_container gform-theme__no-reset--children' ><div id='input_28_96_Container' class='gfield_signature_container ginput_container' style='height:180px; width:320px; ' ><canvas id='input_28_96' width='320' height='180' style='border-style: Dashed; border-width: 2px; border-color: #DDDDDD; background-color:#FFFFFF; cursor: url(https://physiotherapie-oberneuland.digiphysio.app/wp-content/plugins/gravityformssignature/assets/img/pen.cur), pointer;'></canvas></div><div id='input_28_96_toolbar' style='margin:5px 0;position:relative;height:20px;width:320px;max-width:100%;'><img id = 'input_28_96_resetbutton' src='data:image/png;base64,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' style='cursor:pointer;float:right;height:24px;width:24px;border:0px solid transparent' alt='Clear Signature' / ></div><input type='hidden' id='input_28_96_data' name='input_28_96_data' value=''></div></div></div></div>
        <div class='gform-footer gform_footer top_label'> <input type='submit' id='gform_submit_button_28' class='gform_button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='submit' value='Antrag absenden'  /> 
            <input type='hidden' class='gform_hidden' name='gform_submission_method' data-js='gform_submission_method_28' value='postback' />
            <input type='hidden' class='gform_hidden' name='gform_theme' data-js='gform_theme_28' id='gform_theme_28' value='gravity-theme' />
            <input type='hidden' class='gform_hidden' name='gform_style_settings' data-js='gform_style_settings_28' id='gform_style_settings_28' value='[]' />
            <input type='hidden' class='gform_hidden' name='is_submit_28' value='1' />
            <input type='hidden' class='gform_hidden' name='gform_submit' value='28' />
            
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</div><p>Der Beitrag <a href="https://physiotherapie-oberneuland.digiphysio.app/app-daten-loeschen/">App-Daten löschen</a> erschien zuerst auf <a href="https://physiotherapie-oberneuland.digiphysio.app">Physiotherapie Oberneuland</a>.</p>
]]></content:encoded>
					
		
		
			</item>
		<item>
		<title>Bestandspatienten Rezeptanmeldung</title>
		<link>https://physiotherapie-oberneuland.digiphysio.app/bestandspatienten-rezeptanmeldung/</link>
		
		<dc:creator><![CDATA[misterbk]]></dc:creator>
		<pubDate>Tue, 14 May 2024 15:51:37 +0000</pubDate>
				<guid isPermaLink="false">https://physiotherapie-oberneuland.digiphysio.app/?page_id=3434</guid>

					<description><![CDATA[<p>Der Beitrag <a href="https://physiotherapie-oberneuland.digiphysio.app/bestandspatienten-rezeptanmeldung/">Bestandspatienten Rezeptanmeldung</a> erschien zuerst auf <a href="https://physiotherapie-oberneuland.digiphysio.app">Physiotherapie Oberneuland</a>.</p>
]]></description>
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<div class="vc_custom_heading_wrap "><div class="heading-text el-text" ><h2 class="h2 text-color-138907-color" ><span>Rezeptanmeldung</span></h2></div><div class="clear"></div></div>
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									</div><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_27_22'>Akzeptierte Dateitypen: jpeg, jpg, png, pdf, Max. Dateigröße: 10 MB, Max. Dateien: 10.</span><ul class='validation_message--hidden-on-empty gform-ul-reset' id='gform_multifile_messages_27_22'></ul> <div id='gform_preview_27_22' class='ginput_preview_list'></div></div></div><fieldset id="field_27_72" class="gfield gfield--type-consent gfield--type-choice gfield--input-type-consent gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Einwilligung Datenschutz<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></legend><div class='ginput_container ginput_container_consent'><input name='input_72.1' id='input_27_72_1' type='checkbox' value='1'  aria-describedby="gfield_consent_description_27_72" aria-required="true" aria-invalid="false"   /> <label class="gform-field-label gform-field-label--type-inline gfield_consent_label" for='input_27_72_1' >Ich stimme der Datenschutzerklärung zu.</label><input type='hidden' name='input_72.2' value='Ich stimme der Datenschutzerklärung zu.' class='gform_hidden' /><input type='hidden' name='input_72.3' value='66' class='gform_hidden' /></div><div class='gfield_description gfield_consent_description' id='gfield_consent_description_27_72' tabindex='0'>Ich bin einverstanden, dass durch die Praxis Physiotherapie Oberneuland GbR und/oder Physio FIT GbR Kühtmann & Brandt, Mühlenfeldstraße 33c, 28355 Bremen meine Daten zu folgenden Zwecken erhoben, verarbeitet und genutzt werden: Zur Pflege der Kontaktdaten, der Erfüllung des Behandlungsvertrags, zur Abrechnung erbrachter Leistungen mit Krankenkassen, Abrechnungsstellen oder dem Patienten, zur therapeutischen Dokumentation, zum Erstellen von Behandlungsberichten und Arztbriefen sowie zur Abrechnung erbrachter Leistungen. Zu diesen Zwecken können Ihre Daten an den überweisenden Arzt, die Krankenkasse und/oder die Abrechnungsstelle weitergegeben oder werden. Dort werden diese ebenfalls zu folgenden Zwecken verarbeitet und genutzt: Zur Pflege der Kontaktdaten, zur Abrechnung erbrachter Leistungen mit Krankenkassen, zur therapeutischen Dokumentation. Ich bin darauf hingewiesen worden, dass die im Rahmen der vorstehenden genannten Zweck erhobenen persönlichen Daten meiner Person unter Beachtung des DSGVO und des BDSG erhoben, verarbeitet, genutzt und übermittelt werden. Die Erhebung, Verarbeitung und Nutzung meiner Daten auf freiwilliger Basis erfolgt und dass ich mein Einverständnis verweigern mit der Folge, dass der Behandlungsvertrag nicht erfüllt werden kann/nicht zustande kommt und die Behandlung mit der Krankenkasse nicht abgerechnet werden kann. Ich bin jederzeit berechtigt, Auskunft über die zu meiner Person gespeicherten Daten zu verlangen.<br />
Ich bin jederzeit berechtigt, die Berichtigung, Löschung oder Sperrung einzelner Personen bezogener Daten zu verlangen. Ich bin jederzeit berechtigt, mit Wirkung für die Zukunft diese Einwilligungserklärung zu widerrufen.<br />
Im Falle des Widerrufs, ist der Widerruf zu richten an:<br />
Praxis:<br />
Physiotherapie Oberneuland GbR Kühtmann & Brandt<br />
Mühlenfeldstr 33c<br />
28355 Bremen<br />
0421 33004970<br />
info@physiotherapie-oberneuland.com<br />
Im Falle des Widerrufs werden meine Daten nach Ablauf gesetzlicher Fristen und falls solche nicht mehr zu beachten sind, mit dem Zugang der Willenserklärung der Praxis gelöscht. Die Praxis wird meinen Widerruf an die o. g. Dritten weiterleiten, die ihrerseits dann meine Daten löschen.</div></fieldset></div></div>
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</div><p>Der Beitrag <a href="https://physiotherapie-oberneuland.digiphysio.app/bestandspatienten-rezeptanmeldung/">Bestandspatienten Rezeptanmeldung</a> erschien zuerst auf <a href="https://physiotherapie-oberneuland.digiphysio.app">Physiotherapie Oberneuland</a>.</p>
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		<item>
		<title>Datenschutzerklärung</title>
		<link>https://physiotherapie-oberneuland.digiphysio.app/datenschutz/</link>
		
		<dc:creator><![CDATA[misterbk]]></dc:creator>
		<pubDate>Thu, 27 Apr 2023 15:29:49 +0000</pubDate>
				<guid isPermaLink="false">https://demo.digiphysio.app/?page_id=2747</guid>

					<description><![CDATA[<p>Der Beitrag <a href="https://physiotherapie-oberneuland.digiphysio.app/datenschutz/">Datenschutzerklärung</a> erschien zuerst auf <a href="https://physiotherapie-oberneuland.digiphysio.app">Physiotherapie Oberneuland</a>.</p>
]]></description>
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<div class="uncode_text_column" ><div style="word-wrap: break-word;"><h1>Datenschutz­erklärung</h1>
<h2>1. Datenschutz auf einen Blick</h2>
<h3>Allgemeine Hinweise</h3> <p>Die folgenden Hinweise geben einen einfachen Überblick darüber, was mit Ihren personenbezogenen Daten passiert, wenn Sie diese Website besuchen. Personenbezogene Daten sind alle Daten, mit denen Sie persönlich identifiziert werden können. Ausführliche Informationen zum Thema Datenschutz entnehmen Sie unserer unter diesem Text aufgeführten Datenschutzerklärung.</p>
<h3>Datenerfassung auf dieser Website</h3> <h4>Wer ist verantwortlich für die Datenerfassung auf dieser Website?</h4> <p>Die Datenverarbeitung auf dieser Website erfolgt durch den Websitebetreiber. Dessen Kontaktdaten können Sie dem Abschnitt „Hinweis zur Verantwortlichen Stelle“ in dieser Datenschutzerklärung entnehmen.</p> <h4>Wie erfassen wir Ihre Daten?</h4> <p>Ihre Daten werden zum einen dadurch erhoben, dass Sie uns diese mitteilen. Hierbei kann es sich z. B. um Daten handeln, die Sie in ein Kontaktformular eingeben.</p> <p>Andere Daten werden automatisch oder nach Ihrer Einwilligung beim Besuch der Website durch unsere IT-Systeme erfasst. Das sind vor allem technische Daten (z. B. Internetbrowser, Betriebssystem oder Uhrzeit des Seitenaufrufs). Die Erfassung dieser Daten erfolgt automatisch, sobald Sie diese Website betreten.</p> <h4>Wofür nutzen wir Ihre Daten?</h4> <p>Ein Teil der Daten wird erhoben, um eine fehlerfreie Bereitstellung der Website zu gewährleisten. Andere Daten können zur Analyse Ihres Nutzerverhaltens verwendet werden.</p> <h4>Welche Rechte haben Sie bezüglich Ihrer Daten?</h4> <p>Sie haben jederzeit das Recht, unentgeltlich Auskunft über Herkunft, Empfänger und Zweck Ihrer gespeicherten personenbezogenen Daten zu erhalten. Sie haben außerdem ein Recht, die Berichtigung oder Löschung dieser Daten zu verlangen. Wenn Sie eine Einwilligung zur Datenverarbeitung erteilt haben, können Sie diese Einwilligung jederzeit für die Zukunft widerrufen. Außerdem haben Sie das Recht, unter bestimmten Umständen die Einschränkung der Verarbeitung Ihrer personenbezogenen Daten zu verlangen. Des Weiteren steht Ihnen ein Beschwerderecht bei der zuständigen Aufsichtsbehörde zu.</p> <p>Außerdem haben Sie das Recht, unter bestimmten Umständen die Einschränkung der Verarbeitung Ihrer personenbezogenen Daten zu verlangen. Details hierzu entnehmen Sie der Datenschutzerklärung unter „Recht auf Einschränkung der Verarbeitung“.</p>
<h3>Analyse-Tools und Tools von Dritt­anbietern</h3> <p>Beim Besuch dieser Website kann Ihr Surf-Verhalten statistisch ausgewertet werden. Das geschieht vor allem mit sogenannten Analyseprogrammen. Die Analyse Ihres Surf-Verhaltens erfolgt in der Regel anonym; das Surf-Verhalten kann nicht zu Ihnen zurückverfolgt werden.</p> <p>Sie können dieser Analyse widersprechen oder sie durch die Nichtbenutzung bestimmter Tools verhindern. Detaillierte Informationen zu diesen Tools und über Ihre Widerspruchsmöglichkeiten finden Sie in der folgenden Datenschutzerklärung.</p>
<h2>2. Allgemeine Hinweise und Pflicht­informationen</h2>
<h3>Datenschutz</h3> <p>Die Betreiber dieser Seiten nehmen den Schutz Ihrer persönlichen Daten sehr ernst. Wir behandeln Ihre personenbezogenen Daten vertraulich und entsprechend den gesetzlichen Datenschutzvorschriften sowie dieser Datenschutzerklärung.</p> <p>Wenn Sie diese Website benutzen, werden verschiedene personenbezogene Daten erhoben. Personenbezogene Daten sind Daten, mit denen Sie persönlich identifiziert werden können. Die vorliegende Datenschutzerklärung erläutert, welche Daten wir erheben und wofür wir sie nutzen. Sie erläutert auch, wie und zu welchem Zweck das geschieht.</p> <p>Wir weisen darauf hin, dass die Datenübertragung im Internet (z. B. bei der Kommunikation per E-Mail) Sicherheitslücken aufweisen kann. Ein lückenloser Schutz der Daten vor dem Zugriff durch Dritte ist nicht möglich.</p>
<h3>Hinweis zur verantwortlichen Stelle</h3> <p>Die verantwortliche Stelle für die Datenverarbeitung auf dieser Website ist:</p> <p>Physiotherapie Oberneuland Kühtmann + Brandt<br />
Mühlenfeldstraße 33 C<br />
1. Obergeschoss <br />
28355 Bremen</p>

<p>Telefon: +49 (0421) 33 00 49 70<br />
E-Mail: info@physiotherapie-oberneuland.com</p>
 <p>Verantwortliche Stelle ist die natürliche oder juristische Person, die allein oder gemeinsam mit anderen über die Zwecke und Mittel der Verarbeitung von personenbezogenen Daten (z. B. Namen, E-Mail-Adressen o. Ä.) entscheidet.</p>
<h3>Widerruf Ihrer Einwilligung zur Datenverarbeitung</h3> <p>Viele Datenverarbeitungsvorgänge sind nur mit Ihrer ausdrücklichen Einwilligung möglich. Sie können eine bereits erteilte Einwilligung jederzeit widerrufen. Die Rechtmäßigkeit der bis zum Widerruf erfolgten Datenverarbeitung bleibt vom Widerruf unberührt.</p>
<h3>Widerspruchsrecht gegen die Datenerhebung in besonderen Fällen sowie gegen Direktwerbung (Art. 21 DSGVO)</h3> <p>WENN DIE DATENVERARBEITUNG AUF GRUNDLAGE VON ART. 6 ABS. 1 LIT. E ODER F DSGVO ERFOLGT, HABEN SIE JEDERZEIT DAS RECHT, AUS GRÜNDEN, DIE SICH AUS IHRER BESONDEREN SITUATION ERGEBEN, GEGEN DIE VERARBEITUNG IHRER PERSONENBEZOGENEN DATEN WIDERSPRUCH EINZULEGEN; DIES GILT AUCH FÜR EIN AUF DIESE BESTIMMUNGEN GESTÜTZTES PROFILING. DIE JEWEILIGE RECHTSGRUNDLAGE, AUF DENEN EINE VERARBEITUNG BERUHT, ENTNEHMEN SIE DIESER DATENSCHUTZERKLÄRUNG. WENN SIE WIDERSPRUCH EINLEGEN, WERDEN WIR IHRE BETROFFENEN PERSONENBEZOGENEN DATEN NICHT MEHR VERARBEITEN, ES SEI DENN, WIR KÖNNEN ZWINGENDE SCHUTZWÜRDIGE GRÜNDE FÜR DIE VERARBEITUNG NACHWEISEN, DIE IHRE INTERESSEN, RECHTE UND FREIHEITEN ÜBERWIEGEN ODER DIE VERARBEITUNG DIENT DER GELTENDMACHUNG, AUSÜBUNG ODER VERTEIDIGUNG VON RECHTSANSPRÜCHEN (WIDERSPRUCH NACH ART. 21 ABS. 1 DSGVO).</p> <p>WERDEN IHRE PERSONENBEZOGENEN DATEN VERARBEITET, UM DIREKTWERBUNG ZU BETREIBEN, SO HABEN SIE DAS RECHT, JEDERZEIT WIDERSPRUCH GEGEN DIE VERARBEITUNG SIE BETREFFENDER PERSONENBEZOGENER DATEN ZUM ZWECKE DERARTIGER WERBUNG EINZULEGEN; DIES GILT AUCH FÜR DAS PROFILING, SOWEIT ES MIT SOLCHER DIREKTWERBUNG IN VERBINDUNG STEHT. WENN SIE WIDERSPRECHEN, WERDEN IHRE PERSONENBEZOGENEN DATEN ANSCHLIESSEND NICHT MEHR ZUM ZWECKE DER DIREKTWERBUNG VERWENDET (WIDERSPRUCH NACH ART. 21 ABS. 2 DSGVO).</p>
<h3>Beschwerde­recht bei der zuständigen Aufsichts­behörde</h3> <p>Im Falle von Verstößen gegen die DSGVO steht den Betroffenen ein Beschwerderecht bei einer Aufsichtsbehörde, insbesondere in dem Mitgliedstaat ihres gewöhnlichen Aufenthalts, ihres Arbeitsplatzes oder des Orts des mutmaßlichen Verstoßes zu. Das Beschwerderecht besteht unbeschadet anderweitiger verwaltungsrechtlicher oder gerichtlicher Rechtsbehelfe. Eine Liste der Datenschutzbeauftragten sowie deren Kontaktdaten können folgendem Link entnommen werden: https://www.bfdi.bund.de/DE/Service/Anschriften/anschriften_table.html (Deutschland) und https://www.dsb.gv.at/ueber-die-website/kontakt.html (Österreich).</p> 
<h3>Recht auf Daten­übertrag­barkeit</h3> <p>Sie haben das Recht, Daten, die wir auf Grundlage Ihrer Einwilligung oder in Erfüllung eines Vertrags automatisiert verarbeiten, an sich oder an einen Dritten in einem gängigen, maschinenlesbaren Format aushändigen zu lassen. Sofern Sie die direkte Übertragung der Daten an einen anderen Verantwortlichen verlangen, erfolgt dies nur, soweit es technisch machbar ist.</p>
<h3>SSL- bzw. TLS-Verschlüsselung</h3> <p>Diese Seite nutzt aus Sicherheitsgründen und zum Schutz der Übertragung vertraulicher Inhalte, wie zum Beispiel Bestellungen oder Anfragen, die Sie an uns als Seitenbetreiber senden, eine SSL- bzw. TLS-Verschlüsselung. Eine verschlüsselte Verbindung erkennen Sie daran, dass die Adresszeile des Browsers von „http://“ auf „https://“ wechselt und an dem Schloss-Symbol in Ihrer Browserzeile.</p> <p>Wenn die SSL- bzw. TLS-Verschlüsselung aktiviert ist, können die Daten, die Sie an uns übermitteln, nicht von Dritten mitgelesen werden.</p>
<h3>Auskunft, Berichtigung und Löschung</h3> <p>Sie haben im Rahmen der geltenden gesetzlichen Bestimmungen jederzeit das Recht auf unentgeltliche Auskunft über Ihre gespeicherten personenbezogenen Daten, deren Herkunft und Empfänger und den Zweck der Datenverarbeitung und ggf. ein Recht auf Berichtigung oder Löschung dieser Daten. Hierzu sowie zu weiteren Fragen zum Thema personenbezogene Daten können Sie sich jederzeit an uns wenden.</p>
<h3>Recht auf Einschränkung der Verarbeitung</h3> <p>Sie haben das Recht, die Einschränkung der Verarbeitung Ihrer personenbezogenen Daten zu verlangen. Hierzu können Sie sich jederzeit an uns wenden. Das Recht auf Einschränkung der Verarbeitung besteht in folgenden Fällen:</p> <ul> <li>Wenn Sie die Richtigkeit Ihrer bei uns gespeicherten personenbezogenen Daten bestreiten, benötigen wir in der Regel Zeit, um dies zu überprüfen. Für die Dauer der Prüfung haben Sie das Recht, die Einschränkung der Verarbeitung Ihrer personenbezogenen Daten zu verlangen.</li> <li>Wenn die Verarbeitung Ihrer personenbezogenen Daten unrechtmäßig geschah/geschieht, können Sie statt der Löschung die Einschränkung der Datenverarbeitung verlangen.</li> <li>Wenn wir Ihre personenbezogenen Daten nicht mehr benötigen, Sie sie jedoch zur Ausübung, Verteidigung oder Geltendmachung von Rechtsansprüchen benötigen, haben Sie das Recht, statt der Löschung die Einschränkung der Verarbeitung Ihrer personenbezogenen Daten zu verlangen.</li> <li>Wenn Sie einen Widerspruch nach Art. 21 Abs. 1 DSGVO eingelegt haben, muss eine Abwägung zwischen Ihren und unseren Interessen vorgenommen werden. Solange noch nicht feststeht, wessen Interessen überwiegen, haben Sie das Recht, die Einschränkung der Verarbeitung Ihrer personenbezogenen Daten zu verlangen.</li> </ul> <p>Wenn Sie die Verarbeitung Ihrer personenbezogenen Daten eingeschränkt haben, dürfen diese Daten – von ihrer Speicherung abgesehen – nur mit Ihrer Einwilligung oder zur Geltendmachung, Ausübung oder Verteidigung von Rechtsansprüchen oder zum Schutz der Rechte einer anderen natürlichen oder juristischen Person oder aus Gründen eines wichtigen öffentlichen Interesses der Europäischen Union oder eines Mitgliedstaats verarbeitet werden.</p>
<h2>3. APP Hosting</h2>
<p>Wir hosten die Inhalte unserer APP bei folgendem Anbieter:</p>
<h3>All-Inkl</h3> <p>Anbieter ist die ALL-INKL.COM - Neue Medien Münnich, Inh. René Münnich, Hauptstraße 68, 02742 Friedersdorf (nachfolgend All-Inkl). Details entnehmen Sie der Datenschutzerklärung von All-Inkl: <a href="https://all-inkl.com/datenschutzinformationen/" target="_blank" rel="noopener noreferrer">https://all-inkl.com/datenschutzinformationen/</a>.</p> <p>Die Verwendung von All-Inkl erfolgt auf Grundlage von Art. 6 Abs. 1 lit. f DSGVO. Wir haben ein berechtigtes Interesse an einer möglichst zuverlässigen Darstellung unserer Website. Sofern eine entsprechende Einwilligung abgefragt wurde, erfolgt die Verarbeitung ausschließlich auf Grundlage von Art. 6 Abs. 1 lit. a DSGVO und § 25 Abs. 1 TTDSG, soweit die Einwilligung die Speicherung von Cookies oder den Zugriff auf Informationen im Endgerät des Nutzers (z. B. Device-Fingerprinting) im Sinne des TTDSG umfasst. Die Einwilligung ist jederzeit widerrufbar.</p>
<h4>Auftragsverarbeitung</h4> <p>Wir haben einen Vertrag über Auftragsverarbeitung (AVV) zur Nutzung des oben genannten Dienstes geschlossen. Hierbei handelt es sich um einen datenschutzrechtlich vorgeschriebenen Vertrag, der gewährleistet, dass dieser die personenbezogenen Daten unserer Websitebesucher nur nach unseren Weisungen und unter Einhaltung der DSGVO verarbeitet.</p>
<h3>Server-Log-Dateien</h3> <p>Der Provider der Seiten erhebt und speichert automatisch Informationen in so genannten Server-Log-Dateien, die Ihr Browser automatisch an uns übermittelt. Dies sind:</p> <ul> <li>Browsertyp und Browserversion</li> <li>verwendetes Betriebssystem</li> <li>Referrer URL</li> <li>Hostname des zugreifenden Rechners</li> <li>Uhrzeit der Serveranfrage</li> <li>IP-Adresse</li> </ul> <p>Eine Zusammenführung dieser Daten mit anderen Datenquellen wird nicht vorgenommen.</p> <p>Die Erfassung dieser Daten erfolgt auf Grundlage von Art. 6 Abs. 1 lit. f DSGVO. Der Websitebetreiber hat ein berechtigtes Interesse an der technisch fehlerfreien Darstellung und der Optimierung seiner Website – hierzu müssen die Server-Log-Files erfasst werden.</p>
<h3>Kontaktformular</h3> <p>Wenn Sie uns per Kontaktformular Anfragen zukommen lassen, werden Ihre Angaben aus dem Anfrageformular inklusive der von Ihnen dort angegebenen Kontaktdaten zwecks Bearbeitung der Anfrage und für den Fall von Anschlussfragen bei uns gespeichert. Diese Daten geben wir nicht ohne Ihre Einwilligung weiter.</p> <p>Die Verarbeitung dieser Daten erfolgt auf Grundlage von Art. 6 Abs. 1 lit. b DSGVO, sofern Ihre Anfrage mit der Erfüllung eines Vertrags zusammenhängt oder zur Durchführung vorvertraglicher Maßnahmen erforderlich ist. In allen übrigen Fällen beruht die Verarbeitung auf unserem berechtigten Interesse an der effektiven Bearbeitung der an uns gerichteten Anfragen (Art. 6 Abs. 1 lit. f DSGVO) oder auf Ihrer Einwilligung (Art. 6 Abs. 1 lit. a DSGVO) sofern diese abgefragt wurde; die Einwilligung ist jederzeit widerrufbar.</p> <p>Die von Ihnen im Kontaktformular eingegebenen Daten verbleiben bei uns, bis Sie uns zur Löschung auffordern, Ihre Einwilligung zur Speicherung widerrufen oder der Zweck für die Datenspeicherung entfällt (z. B. nach abgeschlossener Bearbeitung Ihrer Anfrage). Zwingende gesetzliche Bestimmungen – insbesondere Aufbewahrungsfristen – bleiben unberührt.</p>
<h3>Anfrage per E-Mail, Telefon oder Telefax</h3> <p>Wenn Sie uns per E-Mail, Telefon oder Telefax kontaktieren, wird Ihre Anfrage inklusive aller daraus hervorgehenden personenbezogenen Daten (Name, Anfrage) zum Zwecke der Bearbeitung Ihres Anliegens bei uns gespeichert und verarbeitet. Diese Daten geben wir nicht ohne Ihre Einwilligung weiter.</p> <p>Die Verarbeitung dieser Daten erfolgt auf Grundlage von Art. 6 Abs. 1 lit. b DSGVO, sofern Ihre Anfrage mit der Erfüllung eines Vertrags zusammenhängt oder zur Durchführung vorvertraglicher Maßnahmen erforderlich ist. In allen übrigen Fällen beruht die Verarbeitung auf unserem berechtigten Interesse an der effektiven Bearbeitung der an uns gerichteten Anfragen (Art. 6 Abs. 1 lit. f DSGVO) oder auf Ihrer Einwilligung (Art. 6 Abs. 1 lit. a DSGVO) sofern diese abgefragt wurde; die Einwilligung ist jederzeit widerrufbar.</p> <p>Die von Ihnen an uns per Kontaktanfragen übersandten Daten verbleiben bei uns, bis Sie uns zur Löschung auffordern, Ihre Einwilligung zur Speicherung widerrufen oder der Zweck für die Datenspeicherung entfällt (z. B. nach abgeschlossener Bearbeitung Ihres Anliegens). Zwingende gesetzliche Bestimmungen – insbesondere gesetzliche Aufbewahrungsfristen – bleiben unberührt.</p>		
<h2>4. Datenerfassung auf dieser Website</h2>
<h3>Cookies</h3>
<p>Die Internetseiten verwenden teilweise so genannte Cookies. Cookies richten auf Ihrem Rechner keinen Schaden an und enthalten keine Viren. Cookies dienen dazu, unser Angebot nutzerfreundlicher, effektiver und sicherer zu machen. Cookies sind kleine Textdateien, die auf Ihrem Rechner abgelegt werden und die Ihr Browser speichert.</p><p>Die meisten der von uns verwendeten Cookies sind so genannte „Session-Cookies“. Sie werden nach Ende Ihres Besuchs automatisch gelöscht. Andere Cookies bleiben auf Ihrem Endgerät gespeichert bis Sie diese löschen. Diese Cookies ermöglichen es uns, Ihren Browser beim nächsten Besuch wiederzuerkennen.</p><p>Sie können Ihren Browser so einstellen, dass Sie über das Setzen von Cookies informiert werden und Cookies nur im Einzelfall erlauben, die Annahme von Cookies für bestimmte Fälle oder generell ausschließen sowie das automatische Löschen der Cookies beim Schließen des Browser aktivieren. Bei der Deaktivierung von Cookies kann die Funktionalität dieser Website eingeschränkt sein.</p><p>Cookies, die zur Durchführung des elektronischen Kommunikationsvorgangs oder zur Bereitstellung bestimmter, von Ihnen erwünschter Funktionen (z. B. Warenkorbfunktion) erforderlich sind, werden auf Grundlage von Art. 6 Abs. 1 lit. f DSGVO gespeichert. Der Websitebetreiber hat ein berechtigtes Interesse an der Speicherung von Cookies zur technisch fehlerfreien und optimierten Bereitstellung seiner Dienste. Soweit andere Cookies (z. B. Cookies zur Analyse Ihres Surfverhaltens) gespeichert werden, werden diese in dieser Datenschutzerklärung gesondert behandelt.</p>
<h3>Verarbeiten von Daten (Kunden- und Vertragsdaten)</h3>
<p>Wir erheben, verarbeiten und nutzen personenbezogene Daten nur, soweit sie für die Begründung, inhaltliche Ausgestaltung oder Änderung des Rechtsverhältnisses erforderlich sind (Bestandsdaten). Dies erfolgt auf Grundlage von Art. 6 Abs. 1 lit. b DSGVO, der die Verarbeitung von Daten zur Erfüllung eines Vertrags oder vorvertraglicher Maßnahmen gestattet. Personenbezogene Daten über die Inanspruchnahme unserer Internetseiten (Nutzungsdaten) erheben, verarbeiten und nutzen wir nur, soweit dies erforderlich ist, um dem Nutzer die Inanspruchnahme des Dienstes zu ermöglichen oder abzurechnen. Die erhobenen Kundendaten werden nach Abschluss des Auftrags oder Beendigung der Geschäftsbeziehung gelöscht. Gesetzliche Aufbewahrungsfristen bleiben unberührt.</p>
<h3>Speicherdauer</h3> <p>Soweit innerhalb dieser Datenschutzerklärung keine speziellere Speicherdauer genannt wurde, verbleiben Ihre personenbezogenen Daten bei uns, bis der Zweck für die Datenverarbeitung entfällt. Wenn Sie ein berechtigtes Löschersuchen geltend machen oder eine Einwilligung zur Datenverarbeitung widerrufen, werden Ihre Daten gelöscht, sofern wir keine anderen rechtlich zulässigen Gründe für die Speicherung Ihrer personenbezogenen Daten haben (z. B. steuer- oder handelsrechtliche Aufbewahrungsfristen); im letztgenannten Fall erfolgt die Löschung nach Fortfall dieser Gründe.</p>
<h3>Allgemeine Hinweise zu den Rechtsgrundlagen der Datenverarbeitung auf dieser Website</h3> <p>Sofern Sie in die Datenverarbeitung eingewilligt haben, verarbeiten wir Ihre personenbezogenen Daten auf Grundlage von Art. 6 Abs. 1 lit. a DSGVO bzw. Art. 9 Abs. 2 lit. a DSGVO, sofern besondere Datenkategorien nach Art. 9 Abs. 1 DSGVO verarbeitet werden. Im Falle einer ausdrücklichen Einwilligung in die Übertragung personenbezogener Daten in Drittstaaten erfolgt die Datenverarbeitung außerdem auf Grundlage von Art. 49 Abs. 1 lit. a DSGVO. Sofern Sie in die Speicherung von Cookies oder in den Zugriff auf Informationen in Ihr Endgerät (z. B. via Device-Fingerprinting) eingewilligt haben, erfolgt die Datenverarbeitung zusätzlich auf Grundlage von § 25 Abs. 1 TTDSG. Die Einwilligung ist jederzeit widerrufbar. Sind Ihre Daten zur Vertragserfüllung oder zur Durchführung vorvertraglicher Maßnahmen erforderlich, verarbeiten wir Ihre Daten auf Grundlage des Art. 6 Abs. 1 lit. b DSGVO. Des Weiteren verarbeiten wir Ihre Daten, sofern diese zur Erfüllung einer rechtlichen Verpflichtung erforderlich sind auf Grundlage von Art. 6 Abs. 1 lit. c DSGVO. Die Datenverarbeitung kann ferner auf Grundlage unseres berechtigten Interesses nach Art. 6 Abs. 1 lit. f DSGVO erfolgen. Über die jeweils im Einzelfall einschlägigen Rechtsgrundlagen wird in den folgenden Absätzen dieser Datenschutzerklärung informiert.</p>
<h3>Empfänger von personenbezogenen Daten</h3> <p>Im Rahmen unserer Geschäftstätigkeit arbeiten wir mit verschiedenen externen Stellen zusammen. Dabei ist teilweise auch eine Übermittlung von personenbezogenen Daten an diese externen Stellen erforderlich. Wir geben personenbezogene Daten nur dann an externe Stellen weiter, wenn dies im Rahmen einer Vertragserfüllung erforderlich ist, wenn wir gesetzlich hierzu verpflichtet sind (z. B. Weitergabe von Daten an Steuerbehörden), wenn wir ein berechtigtes Interesse nach Art. 6 Abs. 1 lit. f DSGVO an der Weitergabe haben oder wenn eine sonstige Rechtsgrundlage die Datenweitergabe erlaubt. Beim Einsatz von Auftragsverarbeitern geben wir personenbezogene Daten unserer Kunden nur auf Grundlage eines gültigen Vertrags über Auftragsverarbeitung weiter. Im Falle einer gemeinsamen Verarbeitung wird ein Vertrag über gemeinsame Verarbeitung geschlossen.</p>		
<h2>5. Plugins und Tools</h2>
<h3>Google Fonts (lokales Hosting)</h3> <p>Diese Seite nutzt zur einheitlichen Darstellung von Schriftarten so genannte Google Fonts, die von Google bereitgestellt werden. Die Google Fonts sind lokal installiert. Eine Verbindung zu Servern von Google findet dabei nicht statt.</p> <p>Weitere Informationen zu Google Fonts finden Sie unter <a href="https://developers.google.com/fonts/faq" target="_blank" rel="noopener noreferrer">https://developers.google.com/fonts/faq</a> und in der Datenschutzerklärung von Google: <a href="https://policies.google.com/privacy?hl=de" target="_blank" rel="noopener noreferrer">https://policies.google.com/privacy?hl=de</a>.</p></div>
</div></div></div></div></div></div><script id="script-row-unique-3" data-row="script-row-unique-3" type="text/javascript" class="vc_controls">UNCODE.initRow(document.getElementById("row-unique-3"));</script></div></div></div>
</div><p>Der Beitrag <a href="https://physiotherapie-oberneuland.digiphysio.app/datenschutz/">Datenschutzerklärung</a> erschien zuerst auf <a href="https://physiotherapie-oberneuland.digiphysio.app">Physiotherapie Oberneuland</a>.</p>
]]></content:encoded>
					
		
		
			</item>
		<item>
		<title>Impressum</title>
		<link>https://physiotherapie-oberneuland.digiphysio.app/impressum/</link>
		
		<dc:creator><![CDATA[misterbk]]></dc:creator>
		<pubDate>Thu, 27 Apr 2023 15:24:51 +0000</pubDate>
				<guid isPermaLink="false">https://demo.digiphysio.app/?page_id=2743</guid>

					<description><![CDATA[<p>Der Beitrag <a href="https://physiotherapie-oberneuland.digiphysio.app/impressum/">Impressum</a> erschien zuerst auf <a href="https://physiotherapie-oberneuland.digiphysio.app">Physiotherapie Oberneuland</a>.</p>
]]></description>
										<content:encoded><![CDATA[<div class="wpb-content-wrapper"><div data-parent="true" class="vc_row row-container" id="row-unique-4"><div class="row limit-width row-parent"><div class="wpb_row row-inner"><div class="wpb_column pos-top pos-center align_left column_parent col-lg-12 single-internal-gutter"><div class="uncol style-light"  ><div class="uncoltable"><div class="uncell no-block-padding" ><div class="uncont" ><div class="vc_row inverted-device-order row-internal row-container"><div class="row unequal col-no-gutter no-top-padding no-bottom-padding no-h-padding row-child"><div class="wpb_row row-inner"><div class="wpb_column pos-top pos-center align_left column_parent col-lg-12 no-internal-gutter"><div class="uncol style-light"  ><div class="uncoltable"><div class="uncell no-block-padding" ><div class="uncont" ><span class="btn-container" ><a role="button"  href="/basis/" class="custom-link btn btn-sm border-width-0 btn-color-138907 btn-flat btn-no-scale btn-icon-left" title="Demoapp Start"><i class="fa fa-arrow-back"></i>Zum Homebildschirm</a></span><div class="empty-space empty-single desktop-hidden" ><span class="empty-space-inner"></span></div>
</div></div></div></div></div></div></div></div>
<div class="uncode_text_column" ><div style="word-wrap: break-word;"><h1>Impressum</h1>

<p>Physiotherapie Oberneuland K&uuml;htmann + Brandt<br />
M&uuml;hlenfeldstra&szlig;e 33 C<br />
1. Obergeschoss<br />
28355 Bremen</p>

<p><strong>Vertreten durch:</strong><br />
Herr Stefan K&uuml;htmann, <br />
Herr Marius Brandt</p>

<h2>Kontakt</h2>
<p>Telefon: +49 (0421) 33 00 49 70<br />
E-Mail: info@physiotherapie-oberneuland.com</p>

<h2>Verbraucher&shy;streit&shy;beilegung/Universal&shy;schlichtungs&shy;stelle</h2>
<p>Wir sind nicht bereit oder verpflichtet, an Streitbeilegungsverfahren vor einer Verbraucherschlichtungsstelle teilzunehmen.</p>

<h2>Zentrale Kontaktstelle nach dem Digital Services Act - DSA (Verordnung (EU) 2022/265)</h2>
<p>Unsere zentrale Kontaktstelle f&uuml;r Nutzer und Beh&ouml;rden nach Art. 11, 12 DSA erreichen Sie wie folgt:</p>
<p>E-Mail: info@physiotherapie-oberneuland.com</p>
<p>Die für den Kontakt zur Verf&uuml;gung stehenden Sprachen sind: Deutsch, Englisch.</p></div>
</div></div></div></div></div></div><script id="script-row-unique-4" data-row="script-row-unique-4" type="text/javascript" class="vc_controls">UNCODE.initRow(document.getElementById("row-unique-4"));</script></div></div></div>
</div><p>Der Beitrag <a href="https://physiotherapie-oberneuland.digiphysio.app/impressum/">Impressum</a> erschien zuerst auf <a href="https://physiotherapie-oberneuland.digiphysio.app">Physiotherapie Oberneuland</a>.</p>
]]></content:encoded>
					
		
		
			</item>
		<item>
		<title>Meine Termine</title>
		<link>https://physiotherapie-oberneuland.digiphysio.app/termine/</link>
		
		<dc:creator><![CDATA[misterbk]]></dc:creator>
		<pubDate>Wed, 26 Apr 2023 10:34:13 +0000</pubDate>
				<guid isPermaLink="false">https://demo.digiphysio.app/?page_id=2692</guid>

					<description><![CDATA[<p>Der Beitrag <a href="https://physiotherapie-oberneuland.digiphysio.app/termine/">Meine Termine</a> erschien zuerst auf <a href="https://physiotherapie-oberneuland.digiphysio.app">Physiotherapie Oberneuland</a>.</p>
]]></description>
										<content:encoded><![CDATA[<div class="wpb-content-wrapper"><div data-parent="true" class="vc_row row-container" id="row-unique-5"><div class="row no-top-padding single-bottom-padding no-h-padding limit-width row-parent"><div class="wpb_row row-inner"><div class="wpb_column pos-top pos-center align_left column_parent col-lg-12 single-internal-gutter"><div class="uncol style-light"  ><div class="uncoltable"><div class="uncell single-block-padding style-color-xsdn-bg has-bg unshadow-darker-std unradius-std" ><div class="uncont" ><div class="vc_row inverted-device-order row-internal row-container"><div class="row unequal col-no-gutter no-top-padding no-bottom-padding no-h-padding row-child"><div class="wpb_row row-inner"><div class="wpb_column pos-top pos-center align_left column_parent col-lg-12 no-internal-gutter"><div class="uncol style-light"  ><div class="uncoltable"><div class="uncell no-block-padding" ><div class="uncont" ><span class="btn-container" ><a role="button"  href="/basis/" class="custom-link btn btn-sm border-width-0 btn-color-138907 btn-flat btn-no-scale btn-icon-left" title="Demoapp Start"><i class="fa fa-arrow-back"></i>Zum Homebildschirm</a></span><div class="empty-space empty-single desktop-hidden" ><span class="empty-space-inner"></span></div>
</div></div></div></div></div></div></div></div>
<div class="vc_custom_heading_wrap "><div class="heading-text el-text" ><h2 class="h2" ><span>Meine Termine</span></h2></div><div class="clear"></div></div>
                <div class='gf_browser_gecko gform_wrapper gravity-theme gform-theme--no-framework' data-form-theme='gravity-theme' data-form-index='0' id='gform_wrapper_19' style='display:none'>
                        <div class='gform_heading'>
							<p class='gform_required_legend'>„<span class="gfield_required gfield_required_asterisk">*</span>“ zeigt erforderliche Felder an</p>
                        </div><form method='post' enctype='multipart/form-data'  id='gform_19'  action='/page_category/demoapp/feed/' data-formid='19' novalidate>
                        <div class='gform-body gform_body'><div id='gform_fields_19' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id="field_19_71" class="gfield gfield--type-honeypot gform_validation_container field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible"  ><label class='gfield_label gform-field-label' for='input_19_71'>Facebook</label><div class='ginput_container'><input name='input_71' id='input_19_71' type='text' value='' autocomplete='new-password'/></div><div class='gfield_description' id='gfield_description_19_71'>Dieses Feld dient zur Validierung und sollte nicht verändert werden.</div></div><div id="field_19_64" class="gfield gfield--type-section gsection field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible"  ><h3 class="gsection_title">Basisangaben</h3><div class='gsection_description' id='gfield_description_19_64'>Sie haben ein Anliegen bezüglich Ihrer Termine, nutzen Sie dieses Formular. Wir melden uns zeitnah bei Ihnen.</div></div><div id="field_19_4" class="gfield gfield--type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"  ><label class='gfield_label gform-field-label' for='input_19_4'>Name<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_text'><input name='input_4' id='input_19_4' type='text' value='' class='large'     aria-required="true" aria-invalid="false"   /></div></div><div id="field_19_3" class="gfield gfield--type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"  ><label class='gfield_label gform-field-label' for='input_19_3'>Vorname<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_text'><input name='input_3' id='input_19_3' type='text' value='' class='large'     aria-required="true" aria-invalid="false"   /></div></div><fieldset id="field_19_6" class="gfield gfield--type-date gfield--input-type-datefield gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Geburtsdatum<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></legend><div id='input_19_6' class='ginput_container ginput_complex gform-grid-row'>
                                        <div class='gfield_date_day ginput_container ginput_container_date gform-grid-col' id='input_19_6_2_container'>
                                            <input type='number' maxlength='2' name='input_6[]' id='input_19_6_2' value=''   aria-required='true'   placeholder='TT' min='1' max='31' step='1'/>
                                            <label for='input_19_6_2' class='gform-field-label gform-field-label--type-sub screen-reader-text'>Tag</label>
                                        </div><div class='gfield_date_month ginput_container ginput_container_date gform-grid-col' id='input_19_6_1_container'>
                                        <input type='number' maxlength='2' name='input_6[]' id='input_19_6_1' value=''   aria-required='true'   placeholder='MM' min='1' max='12' step='1'/>
                                        <label for='input_19_6_1' class='gform-field-label gform-field-label--type-sub screen-reader-text'>Monat</label>
                                   </div><div class='gfield_date_year ginput_container ginput_container_date gform-grid-col' id='input_19_6_3_container'>
                                        <input type='number' maxlength='4' name='input_6[]' id='input_19_6_3' value=''   aria-required='true'   placeholder='JJJJ' min='1920' max='2027' step='1'/>
                                        <label for='input_19_6_3' class='gform-field-label gform-field-label--type-sub screen-reader-text'>Jahr</label>
                                   </div>
                                </div></fieldset><div id="field_19_65" class="gfield gfield--type-html gfield--width-half gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden"  ><script type="text/javascript">
gform.addFilter( 'gform_datepicker_options_pre_init', function( optionsObj, formId, fieldId ) {
if ( formId == 6 && fieldId == 6 ) {
optionsObj.minDate = '-100 Y';
optionsObj.maxDate = '-18 Y';
}
return optionsObj;
} );
</script></div><div id="field_19_61" class="gfield gfield--type-email gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"  ><label class='gfield_label gform-field-label' for='input_19_61'>E-Mail<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_email'>
                            <input name='input_61' id='input_19_61' type='email' value='' class='large'    aria-required="true" aria-invalid="false"  />
                        </div></div><div id="field_19_68" class="gfield gfield--type-section gsection field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible"  ><h3 class="gsection_title">Terminauswahl</h3><div class='gsection_description' id='gfield_description_19_68'>Bitte geben Sie Ihre Terminauswahl an, um Ihr Anliegen besser zuzuordnen.</div></div><div id="field_19_2" class="gfield gfield--type-select gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"  ><label class='gfield_label gform-field-label' for='input_19_2'>Wählen Sie Ihr Terminformular aus:<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_select'><select name='input_2' id='input_19_2' class='large gfield_select'    aria-required="true" aria-invalid="false" ><option value='' selected='selected' class='gf_placeholder'>Terminformular wählen…</option><option value='Ich möchte eine aktuelle Terminübersicht zugesendet bekommen' >Ich möchte eine aktuelle Terminübersicht zugesendet bekommen</option><option value='Ich möchte Folgetermine vereinbaren' >Ich möchte Folgetermine vereinbaren</option><option value='Ich möchte eine meiner bestehenden Termine ändern oder absagen' >Ich möchte eine meiner bestehenden Termine ändern oder absagen</option></select></div></div><div id="field_19_1" class="gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"  ><h3 class="gsection_title">Ich möchte eine aktuelle Terminübersicht zugesendet bekommen</h3></div><fieldset id="field_19_69" class="gfield gfield--type-radio gfield--type-choice gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible"  ><legend class='gfield_label gform-field-label' >Terminübersicht<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></legend><div class='gfield_description' id='gfield_description_19_69'>Hier können Sie wählen, ob Sie alle Termine erhalten wollen oder zu einer bestimmten Behandlung. </div><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_19_69'>
			<div class='gchoice gchoice_19_69_0'>
					<input class='gfield-choice-input' name='input_69' type='radio' value='Alle aktuellen Termine'  id='choice_19_69_0' onchange='gformToggleRadioOther( this )' aria-describedby="gfield_description_19_69"   />
					<label for='choice_19_69_0' id='label_19_69_0' class='gform-field-label gform-field-label--type-inline'>Alle aktuellen Termine</label>
			</div>
			<div class='gchoice gchoice_19_69_1'>
					<input class='gfield-choice-input' name='input_69' type='radio' value='Verordnete/s Heilmittel'  id='choice_19_69_1' onchange='gformToggleRadioOther( this )'    />
					<label for='choice_19_69_1' id='label_19_69_1' class='gform-field-label gform-field-label--type-inline'>Verordnete/s Heilmittel</label>
			</div></div></div></fieldset><div id="field_19_70" class="gfield gfield--type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"  ><label class='gfield_label gform-field-label' for='input_19_70'>Für welche/s verordnete/n Heilmittel benötigen Sie eine Terminübersicht?<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_text'><input name='input_70' id='input_19_70' type='text' value='' class='large'    placeholder='Krankengymnastik, Lymphdrainage usw.' aria-required="true" aria-invalid="false"   /></div></div><div id="field_19_7" class="gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"  ><h3 class="gsection_title">Ich möchte Folgetermine vereinbaren</h3></div><div id="field_19_22" class="gfield gfield--type-fileupload gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible"  ><label class='gfield_label gform-field-label' for='gform_browse_button_19_22'>Upload Folge-Heilmittelverordnung<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='gfield_description' id='gfield_description_19_22'>Gerne können Sie uns das Rezept bereits als Foto hochladen.</div><div class='ginput_container ginput_container_fileupload'><div id='gform_multifile_upload_19_22' data-settings='{&quot;runtimes&quot;:&quot;html5,flash,html4&quot;,&quot;browse_button&quot;:&quot;gform_browse_button_19_22&quot;,&quot;container&quot;:&quot;gform_multifile_upload_19_22&quot;,&quot;drop_element&quot;:&quot;gform_drag_drop_area_19_22&quot;,&quot;filelist&quot;:&quot;gform_preview_19_22&quot;,&quot;unique_names&quot;:true,&quot;file_data_name&quot;:&quot;file&quot;,&quot;url&quot;:&quot;https:\/\/physiotherapie-oberneuland.digiphysio.app\/?gf_page=2a80c7404f24eaf&quot;,&quot;flash_swf_url&quot;:&quot;https:\/\/physiotherapie-oberneuland.digiphysio.app\/wp-includes\/js\/plupload\/plupload.flash.swf&quot;,&quot;silverlight_xap_url&quot;:&quot;https:\/\/physiotherapie-oberneuland.digiphysio.app\/wp-includes\/js\/plupload\/plupload.silverlight.xap&quot;,&quot;filters&quot;:{&quot;mime_types&quot;:[{&quot;title&quot;:&quot;Erlaubte Dateitypen&quot;,&quot;extensions&quot;:&quot;jpeg,jpg,png,pdf&quot;}],&quot;max_file_size&quot;:&quot;20971520b&quot;},&quot;multipart&quot;:true,&quot;urlstream_upload&quot;:false,&quot;multipart_params&quot;:{&quot;form_id&quot;:19,&quot;field_id&quot;:22,&quot;_gform_file_upload_nonce_19_22&quot;:&quot;fe807c81ff&quot;},&quot;gf_vars&quot;:{&quot;max_files&quot;:&quot;10&quot;,&quot;message_id&quot;:&quot;gform_multifile_messages_19_22&quot;,&quot;disallowed_extensions&quot;:[&quot;php&quot;,&quot;asp&quot;,&quot;aspx&quot;,&quot;cmd&quot;,&quot;csh&quot;,&quot;bat&quot;,&quot;html&quot;,&quot;htm&quot;,&quot;hta&quot;,&quot;jar&quot;,&quot;exe&quot;,&quot;com&quot;,&quot;js&quot;,&quot;lnk&quot;,&quot;htaccess&quot;,&quot;phar&quot;,&quot;phtml&quot;,&quot;ps1&quot;,&quot;ps2&quot;,&quot;php3&quot;,&quot;php4&quot;,&quot;php5&quot;,&quot;php6&quot;,&quot;py&quot;,&quot;rb&quot;,&quot;tmp&quot;]}}' class='gform_fileupload_multifile'>
										<div id='gform_drag_drop_area_19_22' class='gform_drop_area gform-theme-field-control'>
											<span class='gform_drop_instructions'>Ziehe Dateien hier her oder </span>
											<button type='button' id='gform_browse_button_19_22' class='button gform_button_select_files gform-theme-button gform-theme-button--control' aria-describedby="gfield_upload_rules_19_22 gfield_description_19_22"  >Wähle Dateien aus</button>
										</div>
									</div><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_19_22'>Akzeptierte Dateitypen: jpeg, jpg, png, pdf, Max. Dateigröße: 20 MB, Max. Dateien: 10.</span><ul class='validation_message--hidden-on-empty gform-ul-reset' id='gform_multifile_messages_19_22'></ul> <div id='gform_preview_19_22' class='ginput_preview_list'></div></div></div><div id="field_19_60" class="gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"  ><h3 class="gsection_title">Ergänzung zur Therapie</h3></div><fieldset id="field_19_59" class="gfield gfield--type-radio gfield--type-choice gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"  ><legend class='gfield_label gform-field-label' >Möchten Sie ihre Therapiezeit um 10 Minuten auf Selbstzahlerbasis verlängern, um schneller und nachhaltiger an Ihr Therapieziel zu gelangen?<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_19_59'>
			<div class='gchoice gchoice_19_59_0'>
					<input class='gfield-choice-input' name='input_59' type='radio' value='Ja'  id='choice_19_59_0' onchange='gformToggleRadioOther( this )'    />
					<label for='choice_19_59_0' id='label_19_59_0' class='gform-field-label gform-field-label--type-inline'>Ja</label>
			</div>
			<div class='gchoice gchoice_19_59_1'>
					<input class='gfield-choice-input' name='input_59' type='radio' value='Nein'  id='choice_19_59_1' onchange='gformToggleRadioOther( this )'    />
					<label for='choice_19_59_1' id='label_19_59_1' class='gform-field-label gform-field-label--type-inline'>Nein</label>
			</div></div></div></fieldset><div id="field_19_9" class="gfield gfield--type-section gsection field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible"  ><h3 class="gsection_title">Wunschzeiten</h3><div class='gsection_description' id='gfield_description_19_9'>Damit wir einfach und schnell planen können, geben Sie uns gerne Ihre Wunschzeiten an.</div></div><fieldset id="field_19_18" class="gfield gfield--type-checkbox gfield--type-choice gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Montag</legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_19_18'><div class='gchoice gchoice_19_18_1'>
								<input class='gfield-choice-input' name='input_18.1' type='checkbox'  value='07.00 - 08.30 Uhr'  id='choice_19_18_1'   />
								<label for='choice_19_18_1' id='label_19_18_1' class='gform-field-label gform-field-label--type-inline'>07.00 - 08.30 Uhr</label>
							</div><div class='gchoice gchoice_19_18_2'>
								<input class='gfield-choice-input' name='input_18.2' type='checkbox'  value='08.30 - 12.00 Uhr'  id='choice_19_18_2'   />
								<label for='choice_19_18_2' id='label_19_18_2' class='gform-field-label gform-field-label--type-inline'>08.30 - 12.00 Uhr</label>
							</div><div class='gchoice gchoice_19_18_3'>
								<input class='gfield-choice-input' name='input_18.3' type='checkbox'  value='12.00 - 14.00 Uhr'  id='choice_19_18_3'   />
								<label for='choice_19_18_3' id='label_19_18_3' class='gform-field-label gform-field-label--type-inline'>12.00 - 14.00 Uhr</label>
							</div><div class='gchoice gchoice_19_18_4'>
								<input class='gfield-choice-input' name='input_18.4' type='checkbox'  value='14.00 - 16.30 Uhr'  id='choice_19_18_4'   />
								<label for='choice_19_18_4' id='label_19_18_4' class='gform-field-label gform-field-label--type-inline'>14.00 - 16.30 Uhr</label>
							</div><div class='gchoice gchoice_19_18_5'>
								<input class='gfield-choice-input' name='input_18.5' type='checkbox'  value='16.30 - 20.00 Uhr'  id='choice_19_18_5'   />
								<label for='choice_19_18_5' id='label_19_18_5' class='gform-field-label gform-field-label--type-inline'>16.30 - 20.00 Uhr</label>
							</div><div class='gchoice gchoice_19_18_6'>
								<input class='gfield-choice-input' name='input_18.6' type='checkbox'  value='flexibel'  id='choice_19_18_6'   />
								<label for='choice_19_18_6' id='label_19_18_6' class='gform-field-label gform-field-label--type-inline'>flexibel</label>
							</div></div></div></fieldset><fieldset id="field_19_14" class="gfield gfield--type-checkbox gfield--type-choice gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Dienstag</legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_19_14'><div class='gchoice gchoice_19_14_1'>
								<input class='gfield-choice-input' name='input_14.1' type='checkbox'  value='07.00 - 08.30 Uhr'  id='choice_19_14_1'   />
								<label for='choice_19_14_1' id='label_19_14_1' class='gform-field-label gform-field-label--type-inline'>07.00 - 08.30 Uhr</label>
							</div><div class='gchoice gchoice_19_14_2'>
								<input class='gfield-choice-input' name='input_14.2' type='checkbox'  value='08.30 - 12.00 Uhr'  id='choice_19_14_2'   />
								<label for='choice_19_14_2' id='label_19_14_2' class='gform-field-label gform-field-label--type-inline'>08.30 - 12.00 Uhr</label>
							</div><div class='gchoice gchoice_19_14_3'>
								<input class='gfield-choice-input' name='input_14.3' type='checkbox'  value='12.00 - 14.00 Uhr'  id='choice_19_14_3'   />
								<label for='choice_19_14_3' id='label_19_14_3' class='gform-field-label gform-field-label--type-inline'>12.00 - 14.00 Uhr</label>
							</div><div class='gchoice gchoice_19_14_4'>
								<input class='gfield-choice-input' name='input_14.4' type='checkbox'  value='14.00 - 16.30 Uhr'  id='choice_19_14_4'   />
								<label for='choice_19_14_4' id='label_19_14_4' class='gform-field-label gform-field-label--type-inline'>14.00 - 16.30 Uhr</label>
							</div><div class='gchoice gchoice_19_14_5'>
								<input class='gfield-choice-input' name='input_14.5' type='checkbox'  value='16.30 - 20.00 Uhr'  id='choice_19_14_5'   />
								<label for='choice_19_14_5' id='label_19_14_5' class='gform-field-label gform-field-label--type-inline'>16.30 - 20.00 Uhr</label>
							</div><div class='gchoice gchoice_19_14_6'>
								<input class='gfield-choice-input' name='input_14.6' type='checkbox'  value='flexibel'  id='choice_19_14_6'   />
								<label for='choice_19_14_6' id='label_19_14_6' class='gform-field-label gform-field-label--type-inline'>flexibel</label>
							</div></div></div></fieldset><fieldset id="field_19_20" class="gfield gfield--type-checkbox gfield--type-choice gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Mittwoch</legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_19_20'><div class='gchoice gchoice_19_20_1'>
								<input class='gfield-choice-input' name='input_20.1' type='checkbox'  value='07.00 - 08.30 Uhr'  id='choice_19_20_1'   />
								<label for='choice_19_20_1' id='label_19_20_1' class='gform-field-label gform-field-label--type-inline'>07.00 - 08.30 Uhr</label>
							</div><div class='gchoice gchoice_19_20_2'>
								<input class='gfield-choice-input' name='input_20.2' type='checkbox'  value='08.30 - 12.00 Uhr'  id='choice_19_20_2'   />
								<label for='choice_19_20_2' id='label_19_20_2' class='gform-field-label gform-field-label--type-inline'>08.30 - 12.00 Uhr</label>
							</div><div class='gchoice gchoice_19_20_3'>
								<input class='gfield-choice-input' name='input_20.3' type='checkbox'  value='12.00 - 14.00 Uhr'  id='choice_19_20_3'   />
								<label for='choice_19_20_3' id='label_19_20_3' class='gform-field-label gform-field-label--type-inline'>12.00 - 14.00 Uhr</label>
							</div><div class='gchoice gchoice_19_20_4'>
								<input class='gfield-choice-input' name='input_20.4' type='checkbox'  value='14.00 - 16.30 Uhr'  id='choice_19_20_4'   />
								<label for='choice_19_20_4' id='label_19_20_4' class='gform-field-label gform-field-label--type-inline'>14.00 - 16.30 Uhr</label>
							</div><div class='gchoice gchoice_19_20_5'>
								<input class='gfield-choice-input' name='input_20.5' type='checkbox'  value='16.30 - 20.00 Uhr'  id='choice_19_20_5'   />
								<label for='choice_19_20_5' id='label_19_20_5' class='gform-field-label gform-field-label--type-inline'>16.30 - 20.00 Uhr</label>
							</div><div class='gchoice gchoice_19_20_6'>
								<input class='gfield-choice-input' name='input_20.6' type='checkbox'  value='flexibel'  id='choice_19_20_6'   />
								<label for='choice_19_20_6' id='label_19_20_6' class='gform-field-label gform-field-label--type-inline'>flexibel</label>
							</div></div></div></fieldset><fieldset id="field_19_19" class="gfield gfield--type-checkbox gfield--type-choice gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Donnerstag</legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_19_19'><div class='gchoice gchoice_19_19_1'>
								<input class='gfield-choice-input' name='input_19.1' type='checkbox'  value='07.00 - 08.30 Uhr'  id='choice_19_19_1'   />
								<label for='choice_19_19_1' id='label_19_19_1' class='gform-field-label gform-field-label--type-inline'>07.00 - 08.30 Uhr</label>
							</div><div class='gchoice gchoice_19_19_2'>
								<input class='gfield-choice-input' name='input_19.2' type='checkbox'  value='08.30 - 12.00 Uhr'  id='choice_19_19_2'   />
								<label for='choice_19_19_2' id='label_19_19_2' class='gform-field-label gform-field-label--type-inline'>08.30 - 12.00 Uhr</label>
							</div><div class='gchoice gchoice_19_19_3'>
								<input class='gfield-choice-input' name='input_19.3' type='checkbox'  value='12.00 - 14.00 Uhr'  id='choice_19_19_3'   />
								<label for='choice_19_19_3' id='label_19_19_3' class='gform-field-label gform-field-label--type-inline'>12.00 - 14.00 Uhr</label>
							</div><div class='gchoice gchoice_19_19_4'>
								<input class='gfield-choice-input' name='input_19.4' type='checkbox'  value='14.00 - 16.30 Uhr'  id='choice_19_19_4'   />
								<label for='choice_19_19_4' id='label_19_19_4' class='gform-field-label gform-field-label--type-inline'>14.00 - 16.30 Uhr</label>
							</div><div class='gchoice gchoice_19_19_5'>
								<input class='gfield-choice-input' name='input_19.5' type='checkbox'  value='16.30 - 20.00 Uhr'  id='choice_19_19_5'   />
								<label for='choice_19_19_5' id='label_19_19_5' class='gform-field-label gform-field-label--type-inline'>16.30 - 20.00 Uhr</label>
							</div><div class='gchoice gchoice_19_19_6'>
								<input class='gfield-choice-input' name='input_19.6' type='checkbox'  value='flexibel'  id='choice_19_19_6'   />
								<label for='choice_19_19_6' id='label_19_19_6' class='gform-field-label gform-field-label--type-inline'>flexibel</label>
							</div></div></div></fieldset><fieldset id="field_19_21" class="gfield gfield--type-checkbox gfield--type-choice gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Freitag</legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_19_21'><div class='gchoice gchoice_19_21_1'>
								<input class='gfield-choice-input' name='input_21.1' type='checkbox'  value='07.00 - 08.30 Uhr'  id='choice_19_21_1'   />
								<label for='choice_19_21_1' id='label_19_21_1' class='gform-field-label gform-field-label--type-inline'>07.00 - 08.30 Uhr</label>
							</div><div class='gchoice gchoice_19_21_2'>
								<input class='gfield-choice-input' name='input_21.2' type='checkbox'  value='08.30 - 12.00 Uhr'  id='choice_19_21_2'   />
								<label for='choice_19_21_2' id='label_19_21_2' class='gform-field-label gform-field-label--type-inline'>08.30 - 12.00 Uhr</label>
							</div><div class='gchoice gchoice_19_21_3'>
								<input class='gfield-choice-input' name='input_21.3' type='checkbox'  value='12.00 - 14.00 Uhr'  id='choice_19_21_3'   />
								<label for='choice_19_21_3' id='label_19_21_3' class='gform-field-label gform-field-label--type-inline'>12.00 - 14.00 Uhr</label>
							</div><div class='gchoice gchoice_19_21_4'>
								<input class='gfield-choice-input' name='input_21.4' type='checkbox'  value='14.00 - 16.30 Uhr'  id='choice_19_21_4'   />
								<label for='choice_19_21_4' id='label_19_21_4' class='gform-field-label gform-field-label--type-inline'>14.00 - 16.30 Uhr</label>
							</div><div class='gchoice gchoice_19_21_5'>
								<input class='gfield-choice-input' name='input_21.5' type='checkbox'  value='16.30 - 20.00 Uhr'  id='choice_19_21_5'   />
								<label for='choice_19_21_5' id='label_19_21_5' class='gform-field-label gform-field-label--type-inline'>16.30 - 20.00 Uhr</label>
							</div><div class='gchoice gchoice_19_21_6'>
								<input class='gfield-choice-input' name='input_21.6' type='checkbox'  value='flexibel'  id='choice_19_21_6'   />
								<label for='choice_19_21_6' id='label_19_21_6' class='gform-field-label gform-field-label--type-inline'>flexibel</label>
							</div></div></div></fieldset><div id="field_19_16" class="gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"  ><h3 class="gsection_title">Ich möchte eine meiner bestehenden Termine ändern oder absagen</h3></div><div id="field_19_51" class="gfield gfield--type-section gsection field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible"  ><h3 class="gsection_title">Alter Termin</h3><div class='gsection_description' id='gfield_description_19_51'>Geben Sie hier Ihren Termin an, den Sie ändern möchten</div></div><fieldset id="field_19_55" class="gfield gfield--type-list gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Ihre alten Termine<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></legend><div class='gfield_description' id='gfield_description_19_55'>Tragen Sie hier Ihre alten Termine ein. 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Klicken Sie auf das Plus-Symbol um mehrere Termine neu zu beantragen.</div><div class='ginput_container ginput_container_list ginput_list ginput_container_list--columns'><div class='gfield_list gfield_list_container'><div class="gfield_list_header gform-grid-row"><div class="gform-field-label gfield_header_item gform-grid-col">Datum</div><div class="gform-field-label gfield_header_item gform-grid-col">Uhrzeit</div><div class="gfield_header_item gfield_header_item--icons gform-grid-col">&nbsp;</div></div><div class="gfield_list_groups"><div class='gfield_list_row_odd gfield_list_group gform-grid-row'><div class='gfield_list_group_item gfield_list_cell gfield_list_56_cell1 gform-grid-col' data-label='Datum'><input aria-invalid='false' aria-required="true" aria-describedby="gfield_description_19_56" aria-label='Datum, Zeile 1' data-aria-label-template='Datum, Zeile {0}' type='text' name='input_56[]' value=''   /></div><div class='gfield_list_group_item gfield_list_cell gfield_list_56_cell2 gform-grid-col' data-label='Uhrzeit'><input aria-invalid='false' aria-required="true" aria-describedby="gfield_description_19_56" aria-label='Uhrzeit, Zeile 1' data-aria-label-template='Uhrzeit, Zeile {0}' type='text' name='input_56[]' value=''   /></div><div class='gfield_list_icons gform-grid-col'>   <button type='button'  class='add_list_item ' aria-label='Eine weitere Zeile hinzufügen' onclick='gformAddListItem(this, 0)'>Hinzufügen</button>   <button type='button'  class='delete_list_item' aria-label='Entferne Zeile 1' data-aria-label-template='Entferne Zeile {0}' onclick='gformDeleteListItem(this, 0)' style="visibility:hidden;">Entfernen</button></div></div></div></div></div></fieldset></div></div>
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</div><p>Der Beitrag <a href="https://physiotherapie-oberneuland.digiphysio.app/termine/">Meine Termine</a> erschien zuerst auf <a href="https://physiotherapie-oberneuland.digiphysio.app">Physiotherapie Oberneuland</a>.</p>
]]></content:encoded>
					
		
		
			</item>
		<item>
		<title>Patientenservice</title>
		<link>https://physiotherapie-oberneuland.digiphysio.app/patientenservice/</link>
		
		<dc:creator><![CDATA[misterbk]]></dc:creator>
		<pubDate>Wed, 26 Apr 2023 10:32:15 +0000</pubDate>
				<guid isPermaLink="false">https://demo.digiphysio.app/?page_id=2688</guid>

					<description><![CDATA[<p>Der Beitrag <a href="https://physiotherapie-oberneuland.digiphysio.app/patientenservice/">Patientenservice</a> erschien zuerst auf <a href="https://physiotherapie-oberneuland.digiphysio.app">Physiotherapie Oberneuland</a>.</p>
]]></description>
										<content:encoded><![CDATA[<div class="wpb-content-wrapper"><div data-parent="true" class="vc_row row-container" id="row-unique-6"><div class="row no-top-padding single-bottom-padding no-h-padding limit-width row-parent"><div class="wpb_row row-inner"><div class="wpb_column pos-top pos-center align_left column_parent col-lg-12 single-internal-gutter"><div class="uncol style-light"  ><div class="uncoltable"><div class="uncell single-block-padding style-color-xsdn-bg has-bg unshadow-darker-std unradius-std" ><div class="uncont" ><div class="vc_row inverted-device-order row-internal row-container"><div class="row unequal col-no-gutter no-top-padding no-bottom-padding no-h-padding row-child"><div class="wpb_row row-inner"><div class="wpb_column pos-top pos-center align_left column_parent col-lg-12 no-internal-gutter"><div class="uncol style-light"  ><div class="uncoltable"><div class="uncell no-block-padding" ><div class="uncont" ><span class="btn-container" ><a role="button"  href="/basis/" class="custom-link btn btn-sm border-width-0 btn-color-138907 btn-flat btn-no-scale btn-icon-left" title="Demoapp Start"><i class="fa fa-arrow-back"></i>Zum Homebildschirm</a></span><div class="empty-space empty-single desktop-hidden" ><span class="empty-space-inner"></span></div>
</div></div></div></div></div></div></div></div>
<div class="vc_custom_heading_wrap "><div class="heading-text el-text" ><h2 class="h2" ><span>Patientenservice</span></h2></div><div class="clear"></div></div>
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							<p class='gform_required_legend'>„<span class="gfield_required gfield_required_asterisk">*</span>“ zeigt erforderliche Felder an</p>
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                        <div class='gform-body gform_body'><div id='gform_fields_20' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id="field_20_58" class="gfield gfield--type-honeypot gform_validation_container field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible"  ><label class='gfield_label gform-field-label' for='input_20_58'>Facebook</label><div class='ginput_container'><input name='input_58' id='input_20_58' type='text' value='' autocomplete='new-password'/></div><div class='gfield_description' id='gfield_description_20_58'>Dieses Feld dient zur Validierung und sollte nicht verändert werden.</div></div><div id="field_20_49" class="gfield gfield--type-section gsection field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible"  ><h3 class="gsection_title">Unser Patientenservice für Sie</h3><div class='gsection_description' id='gfield_description_20_49'>Um Ihnen gezielt weiter helfen zu können, wählen Sie eine unserer Serviceleistungen aus.
<br>
Wir melden uns zeitnah bei Ihnen.</div></div><div id="field_20_57" class="gfield gfield--type-section gsection field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible"  ><h3 class="gsection_title">Basisdaten</h3><div class='gsection_description' id='gfield_description_20_57'>Die Basisdaten benötigen wir zum Abgleich für Ihr Anliegen. </div></div><div id="field_20_2" class="gfield gfield--type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"  ><label class='gfield_label gform-field-label' for='input_20_2'>Name<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_text'><input name='input_2' id='input_20_2' type='text' value='' class='large'     aria-required="true" aria-invalid="false"   /></div></div><div id="field_20_1" class="gfield gfield--type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"  ><label class='gfield_label gform-field-label' for='input_20_1'>Vorname<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_text'><input name='input_1' id='input_20_1' type='text' value='' class='large'     aria-required="true" aria-invalid="false"   /></div></div><fieldset id="field_20_4" class="gfield gfield--type-date gfield--input-type-datefield gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Geburtsdatum<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></legend><div id='input_20_4' class='ginput_container ginput_complex gform-grid-row'>
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gform.initializeOnLoaded( function() {gformInitSpinner( 20, 'https://physiotherapie-oberneuland.digiphysio.app/wp-content/plugins/gravityforms/images/spinner.svg', true );jQuery('#gform_ajax_frame_20').on('load',function(){var contents = jQuery(this).contents().find('*').html();var is_postback = contents.indexOf('GF_AJAX_POSTBACK') >= 0;if(!is_postback){return;}var form_content = jQuery(this).contents().find('#gform_wrapper_20');var is_confirmation = jQuery(this).contents().find('#gform_confirmation_wrapper_20').length > 0;var is_redirect = contents.indexOf('gformRedirect(){') >= 0;var is_form = form_content.length > 0 && ! is_redirect && ! is_confirmation;var mt = parseInt(jQuery('html').css('margin-top'), 10) + parseInt(jQuery('body').css('margin-top'), 10) + 100;if(is_form){form_content.find('form').css('opacity', 0);jQuery('#gform_wrapper_20').html(form_content.html());if(form_content.hasClass('gform_validation_error')){jQuery('#gform_wrapper_20').addClass('gform_validation_error');} else {jQuery('#gform_wrapper_20').removeClass('gform_validation_error');}setTimeout( function() { /* delay the scroll by 50 milliseconds to fix a bug in chrome */  }, 50 );if(window['gformInitDatepicker']) {gformInitDatepicker();}if(window['gformInitPriceFields']) {gformInitPriceFields();}var current_page = jQuery('#gform_source_page_number_20').val();gformInitSpinner( 20, 'https://physiotherapie-oberneuland.digiphysio.app/wp-content/plugins/gravityforms/images/spinner.svg', true );jQuery(document).trigger('gform_page_loaded', [20, current_page]);window['gf_submitting_20'] = false;}else if(!is_redirect){var confirmation_content = jQuery(this).contents().find('.GF_AJAX_POSTBACK').html();if(!confirmation_content){confirmation_content = contents;}jQuery('#gform_wrapper_20').replaceWith(confirmation_content);jQuery(document).trigger('gform_confirmation_loaded', [20]);window['gf_submitting_20'] = false;wp.a11y.speak(jQuery('#gform_confirmation_message_20').text());}else{jQuery('#gform_20').append(contents);if(window['gformRedirect']) {gformRedirect();}}jQuery(document).trigger("gform_pre_post_render", [{ formId: "20", currentPage: "current_page", abort: function() { this.preventDefault(); } }]);        if (event && event.defaultPrevented) {                return;        }        const gformWrapperDiv = document.getElementById( "gform_wrapper_20" );        if ( gformWrapperDiv ) {            const visibilitySpan = document.createElement( "span" );            visibilitySpan.id = "gform_visibility_test_20";            gformWrapperDiv.insertAdjacentElement( "afterend", visibilitySpan );        }        const visibilityTestDiv = document.getElementById( "gform_visibility_test_20" );        let postRenderFired = false;        function triggerPostRender() {            if ( postRenderFired ) {                return;            }            postRenderFired = true;            gform.core.triggerPostRenderEvents( 20, current_page );            if ( visibilityTestDiv ) {                visibilityTestDiv.parentNode.removeChild( visibilityTestDiv );            }        }        function debounce( func, wait, immediate ) {            var timeout;            return function() {                var context = this, args = arguments;                var later = function() {                    timeout = null;                    if ( !immediate ) func.apply( context, args );                };                var callNow = immediate && !timeout;                clearTimeout( timeout );                timeout = setTimeout( later, wait );                if ( callNow ) func.apply( context, args );            };        }        const debouncedTriggerPostRender = debounce( function() {            triggerPostRender();        }, 200 );        if ( visibilityTestDiv && visibilityTestDiv.offsetParent === null ) {            const observer = new MutationObserver( ( mutations ) => {                mutations.forEach( ( mutation ) => {                    if ( mutation.type === 'attributes' && visibilityTestDiv.offsetParent !== null ) {                        debouncedTriggerPostRender();                        observer.disconnect();                    }                });            });            observer.observe( document.body, {                attributes: true,                childList: false,                subtree: true,                attributeFilter: [ 'style', 'class' ],            });        } else {            triggerPostRender();        }    } );} );
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</div><p>Der Beitrag <a href="https://physiotherapie-oberneuland.digiphysio.app/patientenservice/">Patientenservice</a> erschien zuerst auf <a href="https://physiotherapie-oberneuland.digiphysio.app">Physiotherapie Oberneuland</a>.</p>
]]></content:encoded>
					
		
		
			</item>
		<item>
		<title>Feedback</title>
		<link>https://physiotherapie-oberneuland.digiphysio.app/feedback/</link>
		
		<dc:creator><![CDATA[misterbk]]></dc:creator>
		<pubDate>Wed, 26 Apr 2023 10:29:01 +0000</pubDate>
				<guid isPermaLink="false">https://demo.digiphysio.app/?page_id=2682</guid>

					<description><![CDATA[<p>Der Beitrag <a href="https://physiotherapie-oberneuland.digiphysio.app/feedback/">Feedback</a> erschien zuerst auf <a href="https://physiotherapie-oberneuland.digiphysio.app">Physiotherapie Oberneuland</a>.</p>
]]></description>
										<content:encoded><![CDATA[<div class="wpb-content-wrapper"><div data-parent="true" class="vc_row row-container" id="row-unique-7"><div class="row no-top-padding single-bottom-padding no-h-padding limit-width row-parent"><div class="wpb_row row-inner"><div class="wpb_column pos-top pos-center align_left column_parent col-lg-12 no-internal-gutter"><div class="uncol style-light"  ><div class="uncoltable"><div class="uncell single-block-padding style-color-xsdn-bg has-bg unshadow-darker-std unradius-std" ><div class="uncont" ><div class="vc_row inverted-device-order row-internal row-container"><div class="row unequal col-no-gutter no-top-padding no-bottom-padding no-h-padding row-child"><div class="wpb_row row-inner"><div class="wpb_column pos-top pos-center align_left column_parent col-lg-12 no-internal-gutter"><div class="uncol style-light"  ><div class="uncoltable"><div class="uncell no-block-padding" ><div class="uncont" ><span class="btn-container" ><a role="button"  href="/basis/" class="custom-link btn btn-sm border-width-0 btn-color-138907 btn-flat btn-no-scale btn-icon-left" title="Demoapp Start"><i class="fa fa-arrow-back"></i>Zum Homebildschirm</a></span><div class="empty-space empty-single desktop-hidden" ><span class="empty-space-inner"></span></div>
</div></div></div></div></div></div></div></div>
<div class="empty-space empty-single" ><span class="empty-space-inner"></span></div>
<div class="vc_custom_heading_wrap "><div class="heading-text el-text" ><h2 class="h2" ><span>Feedback-Bogen</span></h2></div><div class="clear"></div></div>
                <div class='gf_browser_gecko gform_wrapper gravity-theme gform-theme--no-framework' data-form-theme='gravity-theme' data-form-index='0' id='gform_wrapper_21' style='display:none'>
                        <div class='gform_heading'>
							<p class='gform_required_legend'>„<span class="gfield_required gfield_required_asterisk">*</span>“ zeigt erforderliche Felder an</p>
                        </div><form method='post' enctype='multipart/form-data'  id='gform_21'  action='/page_category/demoapp/feed/' data-formid='21' novalidate>
                        <div class='gform-body gform_body'><div id='gform_fields_21' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id="field_21_19" class="gfield gfield--type-honeypot gform_validation_container field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible"  ><label class='gfield_label gform-field-label' for='input_21_19'>Phone</label><div class='ginput_container'><input name='input_19' id='input_21_19' type='text' value='' autocomplete='new-password'/></div><div class='gfield_description' id='gfield_description_21_19'>Dieses Feld dient zur Validierung und sollte nicht verändert werden.</div></div><div id="field_21_16" class="gfield gfield--type-section gsection field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible"  ><h3 class="gsection_title">Ihr Feedback an uns.</h3><div class='gsection_description' id='gfield_description_21_16'>Liebe:r Patient:in,<br>
um für Sie den besten Service bieten zu können, sind Ihre Erfahrungen für uns sehr wichtig.<br>
Wie hat Ihnen unser Angebot gefallen? Wie können wir Sie noch besser unterstützen? Bitte füllen Sie das unten stehende Formular aus.<br>
Wir freuen uns auf Ihr Feedback.<br>
<br>
Persönliche Rückmeldung, Lob und/&nbsp;oder Anregungen per E-Mail nehmen wir ebenfalls gerne entgegen. <br>
Herzlichst, Ihr Praxis-Team</div></div><div id="field_21_15" class="gfield gfield--type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"  ><label class='gfield_label gform-field-label' for='input_21_15'>Nachname<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_text'><input name='input_15' id='input_21_15' type='text' value='' class='large'     aria-required="true" aria-invalid="false"   /></div></div><div id="field_21_14" class="gfield gfield--type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"  ><label class='gfield_label gform-field-label' for='input_21_14'>Vorname<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_text'><input name='input_14' id='input_21_14' type='text' value='' class='large'     aria-required="true" aria-invalid="false"   /></div></div><fieldset id="field_21_5" class="gfield gfield--type-radio gfield--type-choice gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"  ><legend class='gfield_label gform-field-label' >1.) Welche Aussage trifft auf Sie persönlich zu? Ich…<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_21_5'>
			<div class='gchoice gchoice_21_5_0'>
					<input class='gfield-choice-input' name='input_5' type='radio' value='… freue mich auf jede Behandlung und spüre Fortschritte.'  id='choice_21_5_0' onchange='gformToggleRadioOther( this )'    />
					<label for='choice_21_5_0' id='label_21_5_0' class='gform-field-label gform-field-label--type-inline'>… freue mich auf jede Behandlung und spüre Fortschritte.</label>
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					<input class='gfield-choice-input' name='input_5' type='radio' value='… komme gerne zur Behandlung, aber der Behandlungserfolg könnte größer sein.'  id='choice_21_5_1' onchange='gformToggleRadioOther( this )'    />
					<label for='choice_21_5_1' id='label_21_5_1' class='gform-field-label gform-field-label--type-inline'>… komme gerne zur Behandlung, aber der Behandlungserfolg könnte größer sein.</label>
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			<div class='gchoice gchoice_21_5_2'>
					<input class='gfield-choice-input' name='input_5' type='radio' value='… hatte schon Momente, in denen ich mich frage, ob ich hier gut aufgehoben bin'  id='choice_21_5_2' onchange='gformToggleRadioOther( this )'    />
					<label for='choice_21_5_2' id='label_21_5_2' class='gform-field-label gform-field-label--type-inline'>… hatte schon Momente, in denen ich mich frage, ob ich hier gut aufgehoben bin</label>
			</div></div></div></fieldset><div id="field_21_6" class="gfield gfield--type-survey gfield--input-type-likert gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gsurvey-survey-field "  data-field-class="gsurvey-survey-field" ><label class='gfield_label gform-field-label gfield_label_before_complex' >2.) Bitte bewerten Sie die nachfolgenden Bereiche mit den zutreffenden Smileys.<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_likert'><table aria-label='2.) 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gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"  ><label class='gfield_label gform-field-label' for='input_21_18'>3.) 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</div><p>Der Beitrag <a href="https://physiotherapie-oberneuland.digiphysio.app/feedback/">Feedback</a> erschien zuerst auf <a href="https://physiotherapie-oberneuland.digiphysio.app">Physiotherapie Oberneuland</a>.</p>
]]></content:encoded>
					
		
		
			</item>
		<item>
		<title>Meine Anmeldung</title>
		<link>https://physiotherapie-oberneuland.digiphysio.app/anmeldung/</link>
		
		<dc:creator><![CDATA[misterbk]]></dc:creator>
		<pubDate>Wed, 26 Apr 2023 07:56:54 +0000</pubDate>
				<guid isPermaLink="false">https://demo.digiphysio.app/?page_id=2625</guid>

					<description><![CDATA[<p>Der Beitrag <a href="https://physiotherapie-oberneuland.digiphysio.app/anmeldung/">Meine Anmeldung</a> erschien zuerst auf <a href="https://physiotherapie-oberneuland.digiphysio.app">Physiotherapie Oberneuland</a>.</p>
]]></description>
										<content:encoded><![CDATA[<div class="wpb-content-wrapper"><div data-parent="true" class="vc_row row-container" id="row-unique-8"><div class="row no-top-padding single-bottom-padding no-h-padding limit-width row-parent"><div class="wpb_row row-inner"><div class="wpb_column pos-top pos-center align_left column_parent col-lg-12 single-internal-gutter"><div class="uncol style-light"  ><div class="uncoltable"><div class="uncell single-block-padding style-color-xsdn-bg has-bg unshadow-darker-std unradius-std" ><div class="uncont" ><div class="vc_row inverted-device-order row-internal row-container"><div class="row unequal col-no-gutter no-top-padding no-bottom-padding no-h-padding row-child"><div class="wpb_row row-inner"><div class="wpb_column pos-top pos-center align_left column_parent col-lg-12 no-internal-gutter"><div class="uncol style-light"  ><div class="uncoltable"><div class="uncell no-block-padding" ><div class="uncont" ><span class="btn-container" ><a role="button"  href="/basis/" class="custom-link btn btn-sm border-width-0 btn-color-138907 btn-flat btn-no-scale btn-icon-left" title="Demoapp Start"><i class="fa fa-arrow-back"></i>Zum Homebildschirm</a></span><div class="empty-space empty-single desktop-hidden" ><span class="empty-space-inner"></span></div>
</div></div></div></div></div></div></div></div>
<div class="vc_custom_heading_wrap "><div class="heading-text el-text" ><h2 class="h2" ><span>Meine Anmeldung</span></h2></div><div class="clear"></div></div>
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							<p class='gform_required_legend'>„<span class="gfield_required gfield_required_asterisk">*</span>“ zeigt erforderliche Felder an</p>
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        <div id='gf_progressbar_wrapper_16' class='gf_progressbar_wrapper' data-start-at-zero='1'>
        	<p class="gf_progressbar_title">Schritt <span class='gf_step_current_page'>1</span> von <span class='gf_step_page_count'>7</span><span class='gf_step_page_name'> - Angaben zur Person</span>
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					<div class='gform_page_fields'><div id='gform_fields_16' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id="field_16_81" class="gfield gfield--type-honeypot gform_validation_container field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible"  ><label class='gfield_label gform-field-label' for='input_16_81'>Name</label><div class='ginput_container'><input name='input_81' id='input_16_81' type='text' value='' autocomplete='new-password'/></div><div class='gfield_description' id='gfield_description_16_81'>Dieses Feld dient zur Validierung und sollte nicht verändert werden.</div></div><div id="field_16_26" class="gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible"  ><h3 class="gsection_title">Herzlich Willkommen zur Anmeldung für Ihren Therapiestart</h3><div class='gsection_description' id='gfield_description_16_26'>Wir freuen uns, dass Sie sich für unsere Physio-Praxis entschieden haben.
<br>
Bitte beantworten Sie vor Ihrem ersten Besuch folgende Fragen, damit wir uns optimal auf Sie vorbereiten können und mehr Zeit für Ihre Behandlung zur Verfügung steht.</div></div><div id="field_16_30" class="gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"  ><h3 class="gsection_title">Angaben zur Person</h3></div><fieldset id="field_16_53" class="gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"  ><legend class='gfield_label gform-field-label' >Sind Sie Bestandspatient in unserer Praxis?<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_16_53'>
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                                        <input type='number' maxlength='2' name='input_60[]' id='input_16_60_1' value=''   aria-required='true'   placeholder='MM' min='1' max='12' step='1'/>
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                                        <input type='number' maxlength='4' name='input_60[]' id='input_16_60_3' value=''   aria-required='true'   placeholder='JJJJ' min='1920' max='2027' step='1'/>
                                        <label for='input_16_60_3' class='gform-field-label gform-field-label--type-sub screen-reader-text'>Jahr</label>
                                   </div>
                                </div></fieldset><div id="field_16_61" class="gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden"  ><script type="text/javascript">
gform.addFilter( 'gform_datepicker_options_pre_init', function( optionsObj, formId, fieldId ) {
if ( formId == 16 && fieldId == 60 ) {
optionsObj.minDate = '-100 Y';
optionsObj.maxDate = '-18 Y';
}
return optionsObj;
} );
</script></div><fieldset id="field_16_29" class="gfield gfield--type-address gfield--input-type-address gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Anschrift</legend>    
                    <div class='ginput_complex ginput_container has_street has_city has_zip ginput_container_address gform-grid-row' id='input_16_29' >
                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_16_29_1_container' >
                                        <input type='text' name='input_29.1' id='input_16_29_1' value=''   placeholder='Mühlenfeldstraße 33 C' aria-required='false'    />
                                        <label for='input_16_29_1' id='input_16_29_1_label' class='gform-field-label gform-field-label--type-sub '>Straße / Hausnummer</label>
                                    </span><span class='ginput_left address_zip ginput_address_zip gform-grid-col' id='input_16_29_5_container' >
                                    <input type='text' name='input_29.5' id='input_16_29_5' value=''   placeholder='28355' aria-required='false'    />
                                    <label for='input_16_29_5' id='input_16_29_5_label' class='gform-field-label gform-field-label--type-sub '>PLZ</label>
                                </span><span class='ginput_right address_city ginput_address_city gform-grid-col' id='input_16_29_3_container' >
                                    <input type='text' name='input_29.3' id='input_16_29_3' value=''   placeholder='Bremen' aria-required='false'    />
                                    <label for='input_16_29_3' id='input_16_29_3_label' class='gform-field-label gform-field-label--type-sub '>Ort / Stadt</label>
                                 </span><input type='hidden' class='gform_hidden' name='input_29.4' id='input_16_29_4' value=''/><input type='hidden' class='gform_hidden' name='input_29.6' id='input_16_29_6' value='Deutschland' />
                    <div class='gf_clear gf_clear_complex'></div>
                </div></fieldset><div id="field_16_14" class="gfield gfield--type-email gfield--input-type-email gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"  ><label class='gfield_label gform-field-label' for='input_16_14'>E-Mail<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_email'>
                            <input name='input_14' id='input_16_14' type='email' value='' class='large'   placeholder='info@physiotherapie-oberneuland.com' aria-required="true" aria-invalid="false"  />
                        </div></div><div id="field_16_6" class="gfield gfield--type-phone gfield--input-type-phone gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"  ><label class='gfield_label gform-field-label' for='input_16_6'>Telefon / Mobil</label><div class='ginput_container ginput_container_phone'><input name='input_6' id='input_16_6' type='tel' value='' class='large'  placeholder='(0421) 33 00 49 70'  aria-invalid="false"   /></div></div></div>
                    </div>
                    <div class='gform-page-footer gform_page_footer top_label'>
                         <input type='button' id='gform_next_button_16_34' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Weiter'  /> 
                    </div>
                </div>
                <div id='gform_page_16_2' class='gform_page' data-js='page-field-id-34' style='display:none;'>
                    <div class='gform_page_fields'>
                        <div id='gform_fields_16_2' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id="field_16_54" class="gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"  ><h3 class="gsection_title">Versicherungsstand</h3></div><fieldset id="field_16_35" class="gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"  ><legend class='gfield_label gform-field-label' >Versicherung<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_16_35'>
			<div class='gchoice gchoice_16_35_0'>
					<input class='gfield-choice-input' name='input_35' type='radio' value='Gesetzlich versichert'  id='choice_16_35_0' onchange='gformToggleRadioOther( this )'    />
					<label for='choice_16_35_0' id='label_16_35_0' class='gform-field-label gform-field-label--type-inline'>Gesetzlich versichert</label>
			</div>
			<div class='gchoice gchoice_16_35_1'>
					<input class='gfield-choice-input' name='input_35' type='radio' value='Privat versichert'  id='choice_16_35_1' onchange='gformToggleRadioOther( this )'    />
					<label for='choice_16_35_1' id='label_16_35_1' class='gform-field-label gform-field-label--type-inline'>Privat versichert</label>
			</div>
			<div class='gchoice gchoice_16_35_2'>
					<input class='gfield-choice-input' name='input_35' type='radio' value='Arbeitsunfall / BG'  id='choice_16_35_2' onchange='gformToggleRadioOther( this )'    />
					<label for='choice_16_35_2' id='label_16_35_2' class='gform-field-label gform-field-label--type-inline'>Arbeitsunfall / BG</label>
			</div>
			<div class='gchoice gchoice_16_35_3'>
					<input class='gfield-choice-input' name='input_35' type='radio' value='Ohne Rezept'  id='choice_16_35_3' onchange='gformToggleRadioOther( this )'    />
					<label for='choice_16_35_3' id='label_16_35_3' class='gform-field-label gform-field-label--type-inline'>Ohne Rezept</label>
			</div></div></div></fieldset><div id="field_16_15" class="gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"  ><label class='gfield_label gform-field-label' for='input_16_15'>Krankenkasse<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_text'><input name='input_15' id='input_16_15' type='text' value='' class='large'     aria-required="true" aria-invalid="false"   /></div></div></div>
                    </div>
                    <div class='gform-page-footer gform_page_footer top_label'>
                        <input type='button' id='gform_previous_button_16_36' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Zurück'  /> <input type='button' id='gform_next_button_16_36' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Weiter'  /> 
                    </div>
                </div>
                <div id='gform_page_16_3' class='gform_page' data-js='page-field-id-36' style='display:none;'>
                    <div class='gform_page_fields'>
                        <div id='gform_fields_16_3' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id="field_16_52" class="gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"  ><h3 class="gsection_title">Angaben zur Bestandsaufnahme</h3></div><fieldset id="field_16_18" class="gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"  ><legend class='gfield_label gform-field-label' >Zuzahlung<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_16_18'>
			<div class='gchoice gchoice_16_18_0'>
					<input class='gfield-choice-input' name='input_18' type='radio' value='befreit'  id='choice_16_18_0' onchange='gformToggleRadioOther( this )'    />
					<label for='choice_16_18_0' id='label_16_18_0' class='gform-field-label gform-field-label--type-inline'>befreit</label>
			</div>
			<div class='gchoice gchoice_16_18_1'>
					<input class='gfield-choice-input' name='input_18' type='radio' value='nicht befreit'  id='choice_16_18_1' onchange='gformToggleRadioOther( this )'    />
					<label for='choice_16_18_1' id='label_16_18_1' class='gform-field-label gform-field-label--type-inline'>nicht befreit</label>
			</div></div></div></fieldset><div id="field_16_33" class="gfield gfield--type-fileupload gfield--input-type-fileupload gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible"  ><label class='gfield_label gform-field-label' for='input_16_33'>Upload der Bescheinigung für die Zuzahlungsbefreiung<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='gfield_description' id='gfield_description_16_33'>Hier können Sie Ihre Bescheinigung hochladen.</div><div class='ginput_container ginput_container_fileupload'><input type='hidden' name='MAX_FILE_SIZE' value='10485760' /><input name='input_33' id='input_16_33' type='file' class='large' aria-describedby="gfield_upload_rules_16_33 gfield_description_16_33" onchange='javascript:gformValidateFileSize( this, 10485760 );'  /><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_16_33'>Akzeptierte Dateitypen: jpeg, jpg, png, pdf, Max. Dateigröße: 10 MB.</span><div class='gfield_description validation_message gfield_validation_message validation_message--hidden-on-empty' id='live_validation_message_16_33'></div> </div></div><fieldset id="field_16_17" class="gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"  ><legend class='gfield_label gform-field-label' >Beihilfe berechtigt<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_16_17'>
			<div class='gchoice gchoice_16_17_0'>
					<input class='gfield-choice-input' name='input_17' type='radio' value='Ja'  id='choice_16_17_0' onchange='gformToggleRadioOther( this )'    />
					<label for='choice_16_17_0' id='label_16_17_0' class='gform-field-label gform-field-label--type-inline'>Ja</label>
			</div>
			<div class='gchoice gchoice_16_17_1'>
					<input class='gfield-choice-input' name='input_17' type='radio' value='Nein'  id='choice_16_17_1' onchange='gformToggleRadioOther( this )'    />
					<label for='choice_16_17_1' id='label_16_17_1' class='gform-field-label gform-field-label--type-inline'>Nein</label>
			</div></div></div></fieldset><fieldset id="field_16_55" class="gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"  ><legend class='gfield_label gform-field-label' >Haben Sie Ihre Verordnung bereits hochgeladen?<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_16_55'>
			<div class='gchoice gchoice_16_55_0'>
					<input class='gfield-choice-input' name='input_55' type='radio' value='Ja'  id='choice_16_55_0' onchange='gformToggleRadioOther( this )'    />
					<label for='choice_16_55_0' id='label_16_55_0' class='gform-field-label gform-field-label--type-inline'>Ja</label>
			</div>
			<div class='gchoice gchoice_16_55_1'>
					<input class='gfield-choice-input' name='input_55' type='radio' value='Nein'  id='choice_16_55_1' onchange='gformToggleRadioOther( this )'    />
					<label for='choice_16_55_1' id='label_16_55_1' class='gform-field-label gform-field-label--type-inline'>Nein</label>
			</div>
			<div class='gchoice gchoice_16_55_2'>
					<input class='gfield-choice-input' name='input_55' type='radio' value='Ohne Rezept'  id='choice_16_55_2' onchange='gformToggleRadioOther( this )'    />
					<label for='choice_16_55_2' id='label_16_55_2' class='gform-field-label gform-field-label--type-inline'>Ohne Rezept</label>
			</div></div></div></fieldset><div id="field_16_32" class="gfield gfield--type-fileupload gfield--input-type-fileupload gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible"  ><label class='gfield_label gform-field-label' for='gform_browse_button_16_32'>Upload von Unterlagen<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='gfield_description' id='gfield_description_16_32'>Hier können Sie Ihren Verordnungsschein hochladen oder andere Unterlagen wie z. B. Rezept, Überweisung, Arztbericht u. ä.</div><div class='ginput_container ginput_container_fileupload'><div id='gform_multifile_upload_16_32' data-settings='{&quot;runtimes&quot;:&quot;html5,flash,html4&quot;,&quot;browse_button&quot;:&quot;gform_browse_button_16_32&quot;,&quot;container&quot;:&quot;gform_multifile_upload_16_32&quot;,&quot;drop_element&quot;:&quot;gform_drag_drop_area_16_32&quot;,&quot;filelist&quot;:&quot;gform_preview_16_32&quot;,&quot;unique_names&quot;:true,&quot;file_data_name&quot;:&quot;file&quot;,&quot;url&quot;:&quot;https:\/\/physiotherapie-oberneuland.digiphysio.app\/?gf_page=2a80c7404f24eaf&quot;,&quot;flash_swf_url&quot;:&quot;https:\/\/physiotherapie-oberneuland.digiphysio.app\/wp-includes\/js\/plupload\/plupload.flash.swf&quot;,&quot;silverlight_xap_url&quot;:&quot;https:\/\/physiotherapie-oberneuland.digiphysio.app\/wp-includes\/js\/plupload\/plupload.silverlight.xap&quot;,&quot;filters&quot;:{&quot;mime_types&quot;:[{&quot;title&quot;:&quot;Erlaubte Dateitypen&quot;,&quot;extensions&quot;:&quot;jpeg,jpg,png,pdf&quot;}],&quot;max_file_size&quot;:&quot;10485760b&quot;},&quot;multipart&quot;:true,&quot;urlstream_upload&quot;:false,&quot;multipart_params&quot;:{&quot;form_id&quot;:16,&quot;field_id&quot;:32,&quot;_gform_file_upload_nonce_16_32&quot;:&quot;0ba36e98e9&quot;},&quot;gf_vars&quot;:{&quot;max_files&quot;:&quot;10&quot;,&quot;message_id&quot;:&quot;gform_multifile_messages_16_32&quot;,&quot;disallowed_extensions&quot;:[&quot;php&quot;,&quot;asp&quot;,&quot;aspx&quot;,&quot;cmd&quot;,&quot;csh&quot;,&quot;bat&quot;,&quot;html&quot;,&quot;htm&quot;,&quot;hta&quot;,&quot;jar&quot;,&quot;exe&quot;,&quot;com&quot;,&quot;js&quot;,&quot;lnk&quot;,&quot;htaccess&quot;,&quot;phar&quot;,&quot;phtml&quot;,&quot;ps1&quot;,&quot;ps2&quot;,&quot;php3&quot;,&quot;php4&quot;,&quot;php5&quot;,&quot;php6&quot;,&quot;py&quot;,&quot;rb&quot;,&quot;tmp&quot;]}}' class='gform_fileupload_multifile'>
										<div id='gform_drag_drop_area_16_32' class='gform_drop_area gform-theme-field-control'>
											<span class='gform_drop_instructions'>Ziehe Dateien hier her oder </span>
											<button type='button' id='gform_browse_button_16_32' class='button gform_button_select_files gform-theme-button gform-theme-button--control' aria-describedby="gfield_upload_rules_16_32 gfield_description_16_32"  >Wähle Dateien aus</button>
										</div>
									</div><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_16_32'>Akzeptierte Dateitypen: jpeg, jpg, png, pdf, Max. Dateigröße: 10 MB, Max. Dateien: 10.</span><ul class='validation_message--hidden-on-empty gform-ul-reset' id='gform_multifile_messages_16_32'></ul> <div id='gform_preview_16_32' class='ginput_preview_list'></div></div></div><fieldset id="field_16_45" class="gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible"  ><legend class='gfield_label gform-field-label' >Ergänzung zur Therapie</legend><div class='gfield_description' id='gfield_description_16_45'>Möchten Sie ihre Therapiezeit um 10 Minuten auf Selbstzahlerbasis verlängern, um schneller und nachhaltiger an Ihr Therapieziel zu gelangen?</div><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_16_45'>
			<div class='gchoice gchoice_16_45_0'>
					<input class='gfield-choice-input' name='input_45' type='radio' value='Ja'  id='choice_16_45_0' onchange='gformToggleRadioOther( this )' aria-describedby="gfield_description_16_45"   />
					<label for='choice_16_45_0' id='label_16_45_0' class='gform-field-label gform-field-label--type-inline'>Ja</label>
			</div>
			<div class='gchoice gchoice_16_45_1'>
					<input class='gfield-choice-input' name='input_45' type='radio' value='Nein'  id='choice_16_45_1' onchange='gformToggleRadioOther( this )'    />
					<label for='choice_16_45_1' id='label_16_45_1' class='gform-field-label gform-field-label--type-inline'>Nein</label>
			</div></div></div></fieldset></div>
                    </div>
                    <div class='gform-page-footer gform_page_footer top_label'>
                        <input type='button' id='gform_previous_button_16_37' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Zurück'  /> <input type='button' id='gform_next_button_16_37' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Weiter'  /> 
                    </div>
                </div>
                <div id='gform_page_16_4' class='gform_page' data-js='page-field-id-37' style='display:none;'>
                    <div class='gform_page_fields'>
                        <div id='gform_fields_16_4' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id="field_16_56" class="gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible"  ><h3 class="gsection_title">Wählen Sie Ihren Wunschtermin</h3><div class='gsection_description' id='gfield_description_16_56'>Wir kommen im Anschluss mit einer Terminvereinbarung in Ihrem gewünschten Zeitraum auf Sie zu.</div></div><fieldset id="field_16_39" class="gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-third field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Montag</legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_16_39'><div class='gchoice gchoice_16_39_1'>
								<input class='gfield-choice-input' name='input_39.1' type='checkbox'  value='07.00 - 08.30 Uhr'  id='choice_16_39_1'   />
								<label for='choice_16_39_1' id='label_16_39_1' class='gform-field-label gform-field-label--type-inline'>07.00 - 08.30 Uhr</label>
							</div><div class='gchoice gchoice_16_39_2'>
								<input class='gfield-choice-input' name='input_39.2' type='checkbox'  value='08.30 - 12.00 Uhr'  id='choice_16_39_2'   />
								<label for='choice_16_39_2' id='label_16_39_2' class='gform-field-label gform-field-label--type-inline'>08.30 - 12.00 Uhr</label>
							</div><div class='gchoice gchoice_16_39_3'>
								<input class='gfield-choice-input' name='input_39.3' type='checkbox'  value='12.00 - 14.00 Uhr'  id='choice_16_39_3'   />
								<label for='choice_16_39_3' id='label_16_39_3' class='gform-field-label gform-field-label--type-inline'>12.00 - 14.00 Uhr</label>
							</div><div class='gchoice gchoice_16_39_4'>
								<input class='gfield-choice-input' name='input_39.4' type='checkbox'  value='14.00 - 16.30 Uhr'  id='choice_16_39_4'   />
								<label for='choice_16_39_4' id='label_16_39_4' class='gform-field-label gform-field-label--type-inline'>14.00 - 16.30 Uhr</label>
							</div><div class='gchoice gchoice_16_39_5'>
								<input class='gfield-choice-input' name='input_39.5' type='checkbox'  value='16.30 - 20.00 Uhr'  id='choice_16_39_5'   />
								<label for='choice_16_39_5' id='label_16_39_5' class='gform-field-label gform-field-label--type-inline'>16.30 - 20.00 Uhr</label>
							</div><div class='gchoice gchoice_16_39_6'>
								<input class='gfield-choice-input' name='input_39.6' type='checkbox'  value='flexibel'  id='choice_16_39_6'   />
								<label for='choice_16_39_6' id='label_16_39_6' class='gform-field-label gform-field-label--type-inline'>flexibel</label>
							</div></div></div></fieldset><fieldset id="field_16_40" class="gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-third field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Dienstag</legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_16_40'><div class='gchoice gchoice_16_40_1'>
								<input class='gfield-choice-input' name='input_40.1' type='checkbox'  value='07.00 - 08.30 Uhr'  id='choice_16_40_1'   />
								<label for='choice_16_40_1' id='label_16_40_1' class='gform-field-label gform-field-label--type-inline'>07.00 - 08.30 Uhr</label>
							</div><div class='gchoice gchoice_16_40_2'>
								<input class='gfield-choice-input' name='input_40.2' type='checkbox'  value='08.30 - 12.00 Uhr'  id='choice_16_40_2'   />
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								<label for='choice_16_43_5' id='label_16_43_5' class='gform-field-label gform-field-label--type-inline'>16.30 - 20.00 Uhr</label>
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                        <input type='button' id='gform_previous_button_16_50' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Zurück'  /> <input type='button' id='gform_next_button_16_50' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Weiter'  /> 
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                <div id='gform_page_16_5' class='gform_page' data-js='page-field-id-50' style='display:none;'>
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                        <div id='gform_fields_16_5' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id="field_16_62" class="gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible"  ><h3 class="gsection_title">Aufklärungsbogen</h3><div class='gsection_description' id='gfield_description_16_62'>Liebe/r Patient/in,
nach dem Patientenrechtegesetz sind Physiotherapeuten, ebenso wie Ärzte, zur Aufklärung ihrer Patienten verpflichtet. Dieser Pflicht kommen wir mit dem Aufklärungsbogen sowie der weiteren mündlichen Aufklärung im Rahmen der Behandlungen nach.
Der Aufklärungsbogen dient Ihrer Information, bitte lesen Sie ihn in Ruhe und aufmerksam durch.</div></div><fieldset id="field_16_80" class="gfield gfield--type-consent gfield--type-choice gfield--input-type-consent gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Einverständniserklärung<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></legend><div class='ginput_container ginput_container_consent'><input name='input_80.1' id='input_16_80_1' type='checkbox' value='1'  aria-describedby="gfield_consent_description_16_80" aria-required="true" aria-invalid="false"   /> <label class="gform-field-label gform-field-label--type-inline gfield_consent_label" for='input_16_80_1' >Hiermit bestätige ich den Aufklärungsbogen für Patienten gelesen und verstanden zu haben</label><input type='hidden' name='input_80.2' value='Hiermit bestätige ich den Aufklärungsbogen für Patienten gelesen und verstanden zu haben' class='gform_hidden' /><input type='hidden' name='input_80.3' value='67' class='gform_hidden' /></div><div class='gfield_description gfield_consent_description' id='gfield_consent_description_16_80' tabindex='0'><b>Heilmittel</b><br><br />
<b>Allgemeines:</b><br>Sie haben vom Arzt eine Verordnung zur Heilmittelbehandlung bekommen. Damit Ihre Praxis ordnungsgemäß mit Ihrer Krankenkasse abrechnen kann, müssen bestimmte Bedingungen erfüllt sein. Dieser kleine Leitfaden will Sie darüber informieren, wie Sie Ihre Praxis dabei unterstützen können, dass die Vergütung nicht aus formalen Gründen gekürzt wird. Das hat auch Vorteile für Sie: Bei einem reibungslosen Ablauf können Sie sich besser aufs Gesundwerden konzentrieren.<br><br />
<b>Beginn der Behandlung</b><br>Auf der Verordnung ist das Datum der Ausstellung vermerkt. Nun haben Sie 28 Tage Zeit, um die Behandlung zu beginnen – sofern Ihr Arzt nichts anderes vermerkt hat. Machen Sie, direkt nachdem Sie die Verordnung erhalten haben, einen Termin mit Ihrer Praxis aus. Nach Ablauf der 28-tägigen Frist wird die Verordnung ungültig und die Praxis darf die Behandlung nicht aufnehmen. Sie brauchen dann ein neues Rezept von Ihrem Arzt.<br><br />
<b>Unterbrechung der Behandlung:</b><br>Auf dem Rezept ist vermerkt, wie oft Sie behandelt werden sollen – einmal pro Woche oder öfter (ideal ist hier für alle Beteiligten in den meisten Fällen die Angabe 1-2 Behandlungen pro Woche). Außerdem ist durch die Anzahl der Behandlungseinheiten die Dauer der Behandlungsserie festgelegt. Die Praxis ist an diese Behandlungsfrequenz gebunden. Können Sie den vereinbarten Termin nicht wahrnehmen, sagen Sie bitte 24 Stunden vor Ihrem Termin ab, damit die Praxis Gelegenheit hat, den Termin anderweitig zu vergeben. Sonst berechnet Ihre Praxis Ihnen eine Ausfallgebühr in Höhe der<br />
ausgefallenen Leistung.<br><br />
Sind Sie krank oder fahren Sie in den Urlaub, kann das Rezept 14 Tage unterbrochen werden. Sprechen Sie in diesen Fällen rechtzeitig mit Ihrem Praxis Team. Das gilt auch, wenn Sie stationär in ein Krankenhaus aufgenommen werden. Können Sie länger als zwei Wochen nicht zur Therapie erscheinen, brauchen Sie ein neues Rezept, um die Therapie fortsetzen zu können.<br><br />
<b>Quittieren der Behandlung:</b><br>Auf der Rückseite des Rezepts bestätigen Sie durch Ihre Unterschrift, dass Sie den vereinbarten Behandlungstermin wahrgenommen haben und die auf der Vorderseite des Rezepts vermerkte Therapieform erhalten haben. Der Praxis ist es nicht erlaubt, die Behandlungsdaten zu ändern. Es muss immer das tatsächliche Behandlungsdatum quittiert werden, sonst kann der Praxis ein Betrugsversuch vorgeworfen werden, der ernsthafte Konsequenzen für sie haben kann. Sind Sie nicht selbst in der Lage, auf dem Rezept zu unterschreiben, darf das auch ein von Ihnen bestimmter Stellvertreter tun, zum Beispiel ein Angehöriger oder eine Pflegefachkraft.<br><br />
<b>Erstverordnungen und Folgeverordnungen:</b><br>Die Höchstmenge der Therapieeinheiten ist für jede Krankheit durch die sogenannte Heilmittel-Richtlinie festgelegt. Sie können also für ein und dieselbe Diagnose nicht beliebig viele Therapieeinheiten verordnet bekommen. Auf jede Erstverordnung kann Ihnen Ihr Arzt nur so viele Folgeverordnungen ausstellen, bis diese Höchstmenge erreicht ist. Wenn Sie sich entschließen sollten, die Praxis oder den Arzt zu wechseln, können Sie für die gleiche Diagnose keine neue Erstverordnung bekommen. Das heißt, die Anzahl der möglichen Therapieeinheiten bleibt immer gleich. Sollten Sie vor kurzem bereits in einer anderen Praxis Behandlungen bekommen haben, teilen Sie uns dies bitte mit!<br><br />
<b>Längerfristiger Behandlungsbedarf:</b><br> Sollten aufgrund der Ausprägung Ihres Krankheitsbilds mehr Behandlungseinheiten erforderlich sein, als in der Heilmittel-Richtlinie vorgesehen sind, kann der Arzt von der Höchstverordnungsmenge abweichen. In einigen Fällen bedarf es dazu einer Genehmigung durch Ihre Krankenkasse. Es kann also sein, dass ein entsprechender Antrag gestellt werden muss, bei dem Ihre Mithilfe erforderlich ist. Hat Ihr Arzt festgestellt, dass Ihr Krankheitsbild zu jenen gehört, bei denen die Verordnung einer längerfristigen Heilmittelbehandlung möglich ist, kann er veranlassen, dass die Therapie ein Jahr lang fortgeführt wird. In einigen Fällen bedarf es dazu eines Antrags bei Ihrer Krankenkasse. Dann schreiben Ihr Arzt und gegebenenfalls Ihr Therapeut einen Bericht an die Kasse, um den langfristigen Heilmittelbedarf bei Ihnen zu begründen. Wird ein solcher Bedarf bei Ihnen festgestellt, brauchen Sie nur alle 12 Wochen zum Arzt zu gehen, damit er Ihren Gesundheitszustand und den Verlauf der Therapie beurteilen kann.<br><br />
<b>Zuzahlungen</b><br>Ihre Praxis ist gesetzlich dazu verpflichtet, 10 Euro plus 10 Prozent des Rezeptwerts als Zuzahlung zu verlangen. Dieses Geld zieht er im Auftrag Ihrer Kasse ein. Er kann deshalb nicht eigenmächtig den Betrag verändern. Unter bestimmten Umständen sind Sie von der Zuzahlung befreit oder können einen Teil Ihrer Zuzahlungen von der Kasse zurückerstattet bekommen. Einzelheiten zu diesen Regelungen erfahren Sie von Ihrer Krankenkasse. Zuzahlung ist am ersten Behandlungstag zu bezahlen.</div></fieldset></div>
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                <div id='gform_page_16_6' class='gform_page' data-js='page-field-id-78' style='display:none;'>
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                        <div id='gform_fields_16_6' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id="field_16_57" class="gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible"  ><h3 class="gsection_title">Behandlungsvereinbarung</h3><div class='gsection_description' id='gfield_description_16_57'>Für privat versicherte Personen </div></div><fieldset id="field_16_63" class="gfield gfield--type-consent gfield--type-choice gfield--input-type-consent gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >1. Vergütung der Therapieleistungen Privatpatienten<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></legend><div class='ginput_container ginput_container_consent'><input name='input_63.1' id='input_16_63_1' type='checkbox' value='1'  aria-describedby="gfield_consent_description_16_63" aria-required="true" aria-invalid="false"   /> <label class="gform-field-label gform-field-label--type-inline gfield_consent_label" for='input_16_63_1' >Hiermit bestätige ich die Kenntnisnahme des vorliegenden Sachverhaltes.</label><input type='hidden' name='input_63.2' value='Hiermit bestätige ich die Kenntnisnahme des vorliegenden Sachverhaltes.' class='gform_hidden' /><input type='hidden' name='input_63.3' value='67' class='gform_hidden' /></div><div class='gfield_description gfield_consent_description' id='gfield_consent_description_16_63' tabindex='0'>Die Vergütungssätze für Heilmittel gelten für alle Behandlungen, die ab dem 01.01.2019 begonnen werden. Die Vergütungssätze gelten für: Privatärztlich verordnete physiotherapeutische Heilmittel, die ohne Verordnung angewendet werden (Heilpraktiker- Leistungen, beschränkt auf das Gebiet der Physiotherapie).<br />
Die derzeit gültigen Vergütungssätze für die für den Patient verordneten physiotherapeutischen Therapiemethoden / Leistungen werden dem Patient separat ausgehändigt. Die Vergütungen für Behandlungen werden mit dem Patient direkt abgerechnet und sind unabhängig von einer Kostenerstattung durch die Beihilfestelle und/oder Private Krankenversicherung vom Patient zu zahlen. Der Patient erkundigt sich bei seinem Kostenträger, ob und in welcher Höhe die Kosten für die Maßnahmen der Physiotherapie übernommen werden.<br />
Die Behandlungskosten sind innerhalb von 14 Tagen nach Rechnungsdatum zu zahlen. Mit Überschreitung dieser Zahlungsfrist behalten wir es uns vor, nach weiterer Zahlungsaufforderung oder Mahnung, ein Anspruch auf Berechnung der gesetzlichen Verzugszinsen in Höhe von fünf Prozentpunkten über dem Basiszinssatz zu erheben.</div></fieldset><fieldset id="field_16_64" class="gfield gfield--type-consent gfield--type-choice gfield--input-type-consent gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >2. Abrechnungsstelle<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></legend><div class='ginput_container ginput_container_consent'><input name='input_64.1' id='input_16_64_1' type='checkbox' value='1'  aria-describedby="gfield_consent_description_16_64" aria-required="true" aria-invalid="false"   /> <label class="gform-field-label gform-field-label--type-inline gfield_consent_label" for='input_16_64_1' >Hiermit bestätige ich die Kenntnisnahme des vorliegenden Sachverhaltes.</label><input type='hidden' name='input_64.2' value='Hiermit bestätige ich die Kenntnisnahme des vorliegenden Sachverhaltes.' class='gform_hidden' /><input type='hidden' name='input_64.3' value='67' class='gform_hidden' /></div><div class='gfield_description gfield_consent_description' id='gfield_consent_description_16_64' tabindex='0'>Der Patient bestätigt mit der Weitergabe der zum Zwecke der Abrechnung und Geltendmachung der gegen ihn aus der Behandlung bestehenden Forderung erforderlichen Information an das Rezeptabrechnungszentrum AS Abrechnungsstelle AG einverstanden ist. Der Patient wurde darüber informiert, dass die an das Abrechnungszentrum übermittelten Daten zu seiner Person dort gespeichert werden und diese Erklärung gemäß §&nbsp;33 Bundesdatenschutzgesetz als Benachrichtigung gilt. Die vorstehenden Erklärungen gelten auch für zukünftige Behandlungen und können jederzeit von ihm schriftlich mit Wirkung für die Zukunft widerrufen werden.</div></fieldset><fieldset id="field_16_65" class="gfield gfield--type-consent gfield--type-choice gfield--input-type-consent gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >3. Weitere Vereinbarungen<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></legend><div class='ginput_container ginput_container_consent'><input name='input_65.1' id='input_16_65_1' type='checkbox' value='1'  aria-describedby="gfield_consent_description_16_65" aria-required="true" aria-invalid="false"   /> <label class="gform-field-label gform-field-label--type-inline gfield_consent_label" for='input_16_65_1' >Hiermit bestätige ich die Kenntnisnahme der vorliegenden Sachverhalte.</label><input type='hidden' name='input_65.2' value='Hiermit bestätige ich die Kenntnisnahme der vorliegenden Sachverhalte.' class='gform_hidden' /><input type='hidden' name='input_65.3' value='67' class='gform_hidden' /></div><div class='gfield_description gfield_consent_description' id='gfield_consent_description_16_65' tabindex='0'><b>Kurzfristige Terminabsagen des Patienten</b><br />
Versäumt der Patient einen Termin, ohne ihn 24 Stunden vorher abgesagt zu haben, zahlt er der Praxis den Gegenwert eines stattgefundenen Behandlungstermins. Die Praxis verpflichtet sich, nach Ersatz für die entstandene Terminlücke zu suchen. Im Falle einer Neubelegung verzichtet die Praxis auf die Erhebung der „Ausfallgebühr“.<br><br />
<b>Geltung dieser Vertragsbedingungen</b><br />
Alle Regelungen dieses Behandlungsvertrages gelten für alle Erst- und Folgeverordnungen (kassenärztliche, berufsgenossenschaftliche und privatärztliche Verordnungen), die der Patient der Praxis zwecks Behandlungsdurchführung aushändigt. Gleiches gilt für die Inanspruchnahme von Behandlungen ohne ärztliche Verordnung (sektorale Heilpraktiker- Leistungen). Auch in diesem Fall gelten die vorstehenden Regelungen sowohl für die Erstbehandlung als auch für alle weiteren Folgebehandlungen.<br><br />
<b>Änderungen und Ergänzungen bedürfen der Schriftform</b><br />
Die oben genannten Bedingungen sind für beide Vertragspartner bindend, anders lautende mündliche Absprachen sind in Schriftform festzuhalten.<br><br />
<b>Einverständniserklärung</b><br />
Ich habe die Vertragsbedingungen sorgfältig gelesen und verstanden und erkläre mich mit diesen einverstanden. Die Vergütungssätze (auf individuelle Anfrage – Rezeption) sind mir bekannt. Eine Ausfertigung dieses Behandlungsvertrages ist mir ausgehändigt worden.</div></fieldset><div id="field_16_70" class="gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible"  ><h3 class="gsection_title">Behandlungsvereinbarung</h3><div class='gsection_description' id='gfield_description_16_70'>Für gesetzlich versicherte Personen </div></div><fieldset id="field_16_72" class="gfield gfield--type-consent gfield--type-choice gfield--input-type-consent gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >1. Zuzahlungen und direkte Abrechnung der Praxis mit der Krankenkasse<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></legend><div class='ginput_container ginput_container_consent'><input name='input_72.1' id='input_16_72_1' type='checkbox' value='1'  aria-describedby="gfield_consent_description_16_72" aria-required="true" aria-invalid="false"   /> <label class="gform-field-label gform-field-label--type-inline gfield_consent_label" for='input_16_72_1' >Hiermit bestätige ich die Kenntnisnahme des vorliegenden Sachverhaltes.</label><input type='hidden' name='input_72.2' value='Hiermit bestätige ich die Kenntnisnahme des vorliegenden Sachverhaltes.' class='gform_hidden' /><input type='hidden' name='input_72.3' value='67' class='gform_hidden' /></div><div class='gfield_description gfield_consent_description' id='gfield_consent_description_16_72' tabindex='0'>Als Versicherter einer gesetzlichen Krankenkasse (GKV) entrichten Sie (Patient) im Grundsatz nur die von der Kasse vorgeschriebene Zuzahlung. Dies ist entsprechend dem SGB V in den gültigen Rahmenverträgen mit ihrer Krankenkasse festgelegt.<br />
Die ärztlich verordneten Therapien werden von uns gemäß der Verordnung durchgeführt und direkt mit Ihrem (Patient) Versicherer verrechnet.</div></fieldset><fieldset id="field_16_71" class="gfield gfield--type-consent gfield--type-choice gfield--input-type-consent gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >2. Wirtschaftliche Rückversicherung für zu erbringende Leistungen<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></legend><div class='ginput_container ginput_container_consent'><input name='input_71.1' id='input_16_71_1' type='checkbox' value='1'  aria-describedby="gfield_consent_description_16_71" aria-required="true" aria-invalid="false"   /> <label class="gform-field-label gform-field-label--type-inline gfield_consent_label" for='input_16_71_1' >Hiermit bestätige ich die Kenntnisnahme des vorliegenden Sachverhaltes.</label><input type='hidden' name='input_71.2' value='Hiermit bestätige ich die Kenntnisnahme des vorliegenden Sachverhaltes.' class='gform_hidden' /><input type='hidden' name='input_71.3' value='67' class='gform_hidden' /></div><div class='gfield_description gfield_consent_description' id='gfield_consent_description_16_71' tabindex='0'>Die Prüfung Ihrer (Patient) Verordnung hat vor Behandlungsbeginn ergeben, dass diese ungültig ist. Sie wird dem Arzt vorgelegt. Wenn dieser die Verordnung nicht korrigiert, wird sie evtl. nicht von Ihrer Krankenkasse erstattet. Für den Eintritt dieses Falles verpflichten Sie (Patient) sich, die von der Praxis erstellte Rechnung zu den Sätzen Ihres Versicherers zu begleichen. Die bereits geleistete Zuzahlung wird dabei verrechnet. Hiermit wird dies von Ihnen als Leistungsnehmer ausdrücklich bestätigt und berührt nicht unsere Verträge mit der GKV.</div></fieldset><fieldset id="field_16_73" class="gfield gfield--type-consent gfield--type-choice gfield--input-type-consent gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >3. Weitere Vereinbarungen<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></legend><div class='ginput_container ginput_container_consent'><input name='input_73.1' id='input_16_73_1' type='checkbox' value='1'  aria-describedby="gfield_consent_description_16_73" aria-required="true" aria-invalid="false"   /> <label class="gform-field-label gform-field-label--type-inline gfield_consent_label" for='input_16_73_1' >Hiermit bestätige ich die Kenntnisnahme der vorliegenden Sachverhalte.</label><input type='hidden' name='input_73.2' value='Hiermit bestätige ich die Kenntnisnahme der vorliegenden Sachverhalte.' class='gform_hidden' /><input type='hidden' name='input_73.3' value='67' class='gform_hidden' /></div><div class='gfield_description gfield_consent_description' id='gfield_consent_description_16_73' tabindex='0'><b>Kurzfristige Terminabsagen des Patienten</b><br />
Versäumt der Patient einen Termin, ohne ihn 24 Stunden vorher abgesagt zu haben, zahlt er der Praxis den Gegenwert eines stattgefundenen Behandlungstermins. Die Praxis verpflichtet sich, nach Ersatz für die entstandene Terminlücke zu suchen. Im Falle einer Neubelegung verzichtet die Praxis auf die Erhebung der „Ausfallgebühr“.<br><br />
<b>Geltung dieser Vertragsbedingungen</b><br />
Alle Regelungen dieses Behandlungsvertrages gelten für alle Erst- und Folgeverordnungen (kassenärztliche, berufsgenossenschaftliche und privatärztliche Verordnungen), die der Patient der Praxis zwecks Behandlungsdurchführung aushändigt. Gleiches gilt für die Inanspruchnahme von Behandlungen ohne ärztliche Verordnung (sektorale Heilpraktiker- Leistungen). Auch in diesem Fall gelten die vorstehenden Regelungen sowohl für die Erstbehandlung als auch für alle weiteren Folgebehandlungen.<br><br />
<b>Änderungen und Ergänzungen bedürfen der Schriftform</b><br />
Die oben genannten Bedingungen sind für beide Vertragspartner bindend, anders lautende mündliche Absprachen sind in Schriftform festzuhalten.<br><br />
<b>Einverständniserklärung</b><br />
Ich habe die Vertragsbedingungen sorgfältig gelesen und verstanden und erkläre mich mit diesen einverstanden. Die Vergütungssätze (auf individuelle Anfrage – Rezeption) sind mir bekannt. Eine Ausfertigung dieses Behandlungsvertrages ist mir ausgehändigt worden.<br></div></fieldset></div>
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                        <div id='gform_fields_16_7' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id="field_16_77" class="gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"  ><h3 class="gsection_title">Schlussbestimmungen</h3></div><div id="field_16_19" class="gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"  ><label class='gfield_label gform-field-label' for='input_16_19'>Wie wurden Sie auf uns / unsere Praxis aufmerksam?</label><div class='ginput_container ginput_container_text'><input name='input_19' id='input_16_19' type='text' value='' class='large'      aria-invalid="false"   /></div></div><fieldset id="field_16_48" class="gfield gfield--type-consent gfield--type-choice gfield--input-type-consent gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Ausfallgebühr / Terminabsage<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></legend><div class='ginput_container ginput_container_consent'><input name='input_48.1' id='input_16_48_1' type='checkbox' value='1'  aria-describedby="gfield_consent_description_16_48" aria-required="true" aria-invalid="false"   /> <label class="gform-field-label gform-field-label--type-inline gfield_consent_label" for='input_16_48_1' >Hiermit bestätige ich die Kenntnisnahme des vorliegenden Sachverhaltes.</label><input type='hidden' name='input_48.2' value='Hiermit bestätige ich die Kenntnisnahme des vorliegenden Sachverhaltes.' class='gform_hidden' /><input type='hidden' name='input_48.3' value='67' class='gform_hidden' /></div><div class='gfield_description gfield_consent_description' id='gfield_consent_description_16_48' tabindex='0'>Vereinbarte Behandlungstermine sind spätestens 24 Stunden vorher abzusagen. Für kurzfristig abgesagte oder versäumte Termine müssen wir Ihnen die Kosten für den uns dadurch entstandenen Schaden privat in Rechnung stellen!</div></fieldset><fieldset id="field_16_51" class="gfield gfield--type-consent gfield--type-choice gfield--input-type-consent gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Datenschutzerklärung<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></legend><div class='ginput_container ginput_container_consent'><input name='input_51.1' id='input_16_51_1' type='checkbox' value='1'  aria-describedby="gfield_consent_description_16_51" aria-required="true" aria-invalid="false"   /> <label class="gform-field-label gform-field-label--type-inline gfield_consent_label" for='input_16_51_1' >Hiermit stimme ich der Datenschutzerklärung zu.</label><input type='hidden' name='input_51.2' value='Hiermit stimme ich der Datenschutzerklärung zu.' class='gform_hidden' /><input type='hidden' name='input_51.3' value='67' class='gform_hidden' /></div><div class='gfield_description gfield_consent_description' id='gfield_consent_description_16_51' tabindex='0'>Ich bin einverstanden, dass durch die Praxis Physiotherapie Oberneuland GbR und/oder Physio FIT GbR Kühtmann & Brandt, Mühlenfeldstraße 33c, 28355 Bremen meine Daten zu folgenden Zwecken erhoben, verarbeitet und genutzt werden: Zur Pflege der Kontaktdaten, der Erfüllung des Behandlungsvertrags, zur Abrechnung erbrachter Leistungen mit Krankenkassen, Abrechnungsstellen oder dem Patienten, zur therapeutischen Dokumentation, zum Erstellen von Behandlungsberichten und Arztbriefen sowie zur Abrechnung erbrachter Leistungen. Zu diesen Zwecken können Ihre Daten an den überweisenden Arzt, die Krankenkasse und/oder die Abrechnungsstelle weitergegeben oder werden. Dort werden diese ebenfalls zu folgenden Zwecken verarbeitet und genutzt: Zur Pflege der Kontaktdaten, zur Abrechnung erbrachter Leistungen mit Krankenkassen, zur therapeutischen Dokumentation. Ich bin darauf hingewiesen worden, dass die im Rahmen der vorstehenden genannten Zweck erhobenen persönlichen Daten meiner Person unter Beachtung des DSGVO und des BDSG erhoben, verarbeitet, genutzt und übermittelt werden. Die Erhebung, Verarbeitung und Nutzung meiner Daten auf freiwilliger Basis erfolgt und dass ich mein Einverständnis verweigern mit der Folge, dass der Behandlungsvertrag nicht erfüllt werden kann/nicht zustande kommt und die Behandlung mit der Krankenkasse nicht abgerechnet werden kann. Ich bin jederzeit berechtigt, Auskunft über die zu meiner Person gespeicherten Daten zu verlangen.<br />
Ich bin jederzeit berechtigt, die Berichtigung, Löschung oder Sperrung einzelner Personen bezogener Daten zu verlangen. Ich bin jederzeit berechtigt, mit Wirkung für die Zukunft diese Einwilligungserklärung zu widerrufen.<br />
Im Falle des Widerrufs, ist der Widerruf zu richten an:<br />
Praxis:<br />
Physiotherapie Oberneuland GbR Kühtmann & Brandt<br />
Mühlenfeldstr 33c<br />
28355 Bremen<br />
0421 33004970<br />
info@physiotherapie-oberneuland.com<br />
Im Falle des Widerrufs werden meine Daten nach Ablauf gesetzlicher Fristen und falls solche nicht mehr zu beachten sind, mit dem Zugang der Willenserklärung der Praxis gelöscht. Die Praxis wird meinen Widerruf an die o. g. Dritten weiterleiten, die ihrerseits dann meine Daten löschen.</div></fieldset><div id="field_16_22" class="gfield gfield--type-signature gfield--input-type-signature gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"  ><label class='gfield_label gform-field-label' for='input_16_22'>Unterschrift</label><input type='hidden' value='' name='input_22' id='input_16_22_signature_filename'/><div class='gfield_signature_ui_container gform-theme__no-reset--children' ><div id='input_16_22_Container' class='gfield_signature_container ginput_container' style='height:180px; width:320px; ' ><canvas id='input_16_22' width='320' height='180' style='border-style: Dashed; border-width: 2px; border-color: #DDDDDD; background-color:#FFFFFF; cursor: url(https://physiotherapie-oberneuland.digiphysio.app/wp-content/plugins/gravityformssignature/assets/img/pen.cur), pointer;'></canvas></div><div id='input_16_22_toolbar' style='margin:5px 0;position:relative;height:20px;width:320px;max-width:100%;'><img id = 'input_16_22_resetbutton' src='data:image/png;base64,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' style='cursor:pointer;float:right;height:24px;width:24px;border:0px solid transparent' alt='Clear Signature' / ></div><input type='hidden' id='input_16_22_data' name='input_16_22_data' value=''></div></div></div></div>
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</div><p>Der Beitrag <a href="https://physiotherapie-oberneuland.digiphysio.app/anmeldung/">Meine Anmeldung</a> erschien zuerst auf <a href="https://physiotherapie-oberneuland.digiphysio.app">Physiotherapie Oberneuland</a>.</p>
]]></content:encoded>
					
		
		
			</item>
		<item>
		<title>Herzlich Willkommen</title>
		<link>https://physiotherapie-oberneuland.digiphysio.app/</link>
		
		<dc:creator><![CDATA[misterbk]]></dc:creator>
		<pubDate>Wed, 26 Apr 2023 07:45:29 +0000</pubDate>
				<guid isPermaLink="false">https://demo.digiphysio.app/?page_id=2615</guid>

					<description><![CDATA[<p>Der Beitrag <a href="https://physiotherapie-oberneuland.digiphysio.app/">Herzlich Willkommen</a> erschien zuerst auf <a href="https://physiotherapie-oberneuland.digiphysio.app">Physiotherapie Oberneuland</a>.</p>
]]></description>
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										</div><div class="uncont" ><div class="icon-box icon-box-top" ><div class="icon-box-icon fa-container"><a role="button" href="/leistungen/" title="Leistungen" aria-label="Leistungen" class="text-default-color custom-link"><span id="icon-618598" style="width:46px" class="icon-media"><img decoding="async" src="https://physiotherapie-oberneuland.digiphysio.app/wp-content/uploads/2023/01/app-icons_45x45px_Leistungen.svg" alt="Leistungen" /></span></a></div><div class="icon-box-content"><div class="icon-box-heading icon-box-fa-1x"><h6 class="h6">LEISTUNGEN</h6></div></div></div></div></div></div></div><a class="col-link custom-link" href="/leistungen/" target="_self" title="Leistungen"></a></div></div></div></div><div class="vc_row row-internal row-container"><div class="row unequal col-one-gutter row-child" data-minheight="300"><div class="wpb_row row-inner"><div class="wpb_column pos-middle pos-center align_center column_child col-lg-6 tablet-height col-md-50 col-sm-50 single-internal-gutter"><div class="uncol style-light" ><div class="uncoltable"><div class="uncell  vc_custom_1715703274515 no-block-padding" style="padding-top: 42px ;padding-right: 35px ;padding-bottom: 42px ;padding-left: 35px ;" ><div class="column-background background-element" style="opacity: 1;">
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</div><p>Der Beitrag <a href="https://physiotherapie-oberneuland.digiphysio.app/">Herzlich Willkommen</a> erschien zuerst auf <a href="https://physiotherapie-oberneuland.digiphysio.app">Physiotherapie Oberneuland</a>.</p>
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