{"id":661,"date":"2021-11-30T10:52:10","date_gmt":"2021-11-30T10:52:10","guid":{"rendered":"https:\/\/webszh.uk-halle.de\/beonet\/?page_id=661"},"modified":"2022-08-13T16:59:29","modified_gmt":"2022-08-13T16:59:29","slug":"interessensformular","status":"publish","type":"page","link":"https:\/\/webszh.uk-halle.de\/beonet\/index.php\/interessensformular\/","title":{"rendered":"Interessensformular"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"661\" class=\"elementor elementor-661\">\n\t\t\t\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-c74d80b elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"c74d80b\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-35eaa85\" data-id=\"35eaa85\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t\t\t<div class=\"elementor-element elementor-element-d09f3cf elementor-widget elementor-widget-text-editor\" data-id=\"d09f3cf\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<p><span style=\"color: #181a18; font-family: Helvetica, Helvetica; font-size: 14px; font-weight: var( --e-global-typography-text-font-weight );\">Bitte f\u00fcllen Sie das nachstehende Onlineformular aus, wenn Sie Interesse daran haben, dem Beobachtungspraxen-Netzwerk Halle beizutreten.<\/span><\/p><p style=\"color: #181a18; font-family: Helvetica, Helvetica; font-size: 14px;\"><span class=\"VIiyi\" lang=\"de\">Bei Fragen kontaktieren Sie uns gerne unter 0345 557 4222 oder unter <a href=\"mailto:beonet@uk-halle.de\"><span style=\"color: #960000;\">beonet@uk-halle.de<\/span><\/a>.<\/span><\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-8caac03 elementor-widget elementor-widget-heading\" data-id=\"8caac03\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Interessensformular<\/h2>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-df98871 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"df98871\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-096ccee\" data-id=\"096ccee\" data-element_type=\"column\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t\t\t<div class=\"elementor-element elementor-element-26283f3 elementor-button-align-start elementor-widget elementor-widget-form\" data-id=\"26283f3\" data-element_type=\"widget\" data-settings=\"{&quot;step_next_label&quot;:&quot;Next&quot;,&quot;step_previous_label&quot;:&quot;Previous&quot;,&quot;button_width&quot;:&quot;40&quot;,&quot;step_type&quot;:&quot;number_text&quot;,&quot;step_icon_shape&quot;:&quot;circle&quot;}\" data-widget_type=\"form.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<form class=\"elementor-form\" method=\"post\" name=\"Interessensformular\">\n\t\t\t<input type=\"hidden\" name=\"post_id\" value=\"661\"\/>\n\t\t\t<input type=\"hidden\" name=\"form_id\" value=\"26283f3\"\/>\n\t\t\t<input type=\"hidden\" name=\"referer_title\" value=\"\" \/>\n\n\t\t\t\n\t\t\t<div class=\"elementor-form-fields-wrapper elementor-labels-above\">\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-select elementor-field-group elementor-column elementor-field-group-field_aec0185 elementor-col-20\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_aec0185\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tTitel\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field elementor-select-wrapper \">\n\t\t\t<select name=\"form_fields[field_aec0185]\" id=\"form-field-field_aec0185\" class=\"elementor-field-textual elementor-size-xs\">\n\t\t\t\t\t\t\t\t\t<option value=\" \"> <\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Dr.\">Dr.<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Prof.\">Prof.<\/option>\n\t\t\t\t\t\t\t<\/select>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_cb9d600 elementor-col-30 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_cb9d600\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tVor- und Nachname\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[field_cb9d600]\" id=\"form-field-field_cb9d600\" class=\"elementor-field elementor-size-xs  elementor-field-textual\" required=\"required\" aria-required=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-tel elementor-field-group elementor-column elementor-field-group-field_9d0665f elementor-col-20\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_9d0665f\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tErreichbarkeit\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t<input size=\"1\" type=\"tel\" name=\"form_fields[field_9d0665f]\" id=\"form-field-field_9d0665f\" class=\"elementor-field elementor-size-xs  elementor-field-textual\" pattern=\"[0-9()#&amp;+*-=.]+\" title=\"Nur Nummern oder Telefon-Zeichen (#, -, *, etc) werden akzeptiert.\">\n\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-name elementor-col-30 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-name\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tName der teilnehmenden Praxis\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[name]\" id=\"form-field-name\" class=\"elementor-field elementor-size-xs  elementor-field-textual\" required=\"required\" aria-required=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_55e24fd elementor-col-30 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_55e24fd\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tStra\u00dfe und Hausnummer\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[field_55e24fd]\" id=\"form-field-field_55e24fd\" class=\"elementor-field elementor-size-xs  elementor-field-textual\" required=\"required\" aria-required=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_15496b4 elementor-col-20 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_15496b4\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tPostleitzahl\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[field_15496b4]\" id=\"form-field-field_15496b4\" class=\"elementor-field elementor-size-xs  elementor-field-textual\" required=\"required\" aria-required=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_ff8b499 elementor-col-20\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_ff8b499\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tStadt\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[field_ff8b499]\" id=\"form-field-field_ff8b499\" class=\"elementor-field elementor-size-xs  elementor-field-textual\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-email elementor-field-group elementor-column elementor-field-group-email elementor-col-30 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-email\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tE-mail Adresse\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"email\" name=\"form_fields[email]\" id=\"form-field-email\" class=\"elementor-field elementor-size-xs  elementor-field-textual\" required=\"required\" aria-required=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_2665f47 elementor-col-30\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_2665f47\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tName Ihrer Praxissoftware\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[field_2665f47]\" id=\"form-field-field_2665f47\" class=\"elementor-field elementor-size-xs  elementor-field-textual\" placeholder=\"Praxissoftwareanbieter\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-checkbox elementor-field-group elementor-column elementor-field-group-message elementor-col-30\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-message\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tGrund zur Teilnahme am Register\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<div class=\"elementor-field-subgroup  \"><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Zur Qualit\u00e4tsverbesserung\" id=\"form-field-message-0\" name=\"form_fields[message][]\"> <label for=\"form-field-message-0\">Zur Qualit\u00e4tsverbesserung<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Teilnahme an klinischen Studien\" id=\"form-field-message-1\" name=\"form_fields[message][]\"> <label for=\"form-field-message-1\">Teilnahme an klinischen Studien<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Teilnahme an einem Forschungspraxennetzwerk\" id=\"form-field-message-2\" name=\"form_fields[message][]\"> <label for=\"form-field-message-2\">Teilnahme an einem Forschungspraxennetzwerk<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Andere Gr\u00fcnde\" id=\"form-field-message-3\" name=\"form_fields[message][]\"> <label for=\"form-field-message-3\">Andere Gr\u00fcnde<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-checkbox elementor-field-group elementor-column elementor-field-group-field_880cb45 elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_880cb45\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tZutreffende Felder bitte ankreuzen\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<div class=\"elementor-field-subgroup  \"><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Ich interessiere mich f\u00fcr die Teilnahme am BeoNet Halle Register\" id=\"form-field-field_880cb45-0\" name=\"form_fields[field_880cb45][]\"> <label for=\"form-field-field_880cb45-0\">Ich interessiere mich f\u00fcr die Teilnahme am BeoNet Halle Register<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Bitte senden Sie mir weitere Infomaterialien an die o.g. Adresse\" id=\"form-field-field_880cb45-1\" name=\"form_fields[field_880cb45][]\"> <label for=\"form-field-field_880cb45-1\">Bitte senden Sie mir weitere Infomaterialien an die o.g. Adresse<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Ich gestatte Ihnen, mich zwecks der Teilnahme am Register zu kontaktieren\" id=\"form-field-field_880cb45-2\" name=\"form_fields[field_880cb45][]\"> <label for=\"form-field-field_880cb45-2\">Ich gestatte Ihnen, mich zwecks der Teilnahme am Register zu kontaktieren<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_9f12c00 elementor-col-30\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_9f12c00\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tGew\u00fcnschter Kontakttermin\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[field_9f12c00]\" id=\"form-field-field_9f12c00\" class=\"elementor-field elementor-size-xs  elementor-field-textual\" placeholder=\"Datum und Uhrzeit\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-textarea elementor-field-group elementor-column elementor-field-group-field_9ce66e6 elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_9ce66e6\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tNachricht (Optional)\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<textarea class=\"elementor-field-textual elementor-field  elementor-size-xs\" name=\"form_fields[field_9ce66e6]\" id=\"form-field-field_9ce66e6\" rows=\"4\"><\/textarea>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-group elementor-column elementor-field-type-submit elementor-col-40 e-form__buttons\">\n\t\t\t\t\t<button type=\"submit\" class=\"elementor-button elementor-size-xs\">\n\t\t\t\t\t\t<span >\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\" elementor-button-icon\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">Senden<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/button>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/form>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Bitte f\u00fcllen Sie das nachstehende Onlineformular aus, wenn Sie Interesse daran haben, dem Beobachtungspraxen-Netzwerk Halle beizutreten. Bei Fragen kontaktieren Sie uns gerne unter 0345 557 4222 oder unter beonet@uk-halle.de. Interessensformular<\/p>\n","protected":false},"author":2,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":[],"_links":{"self":[{"href":"https:\/\/webszh.uk-halle.de\/beonet\/index.php\/wp-json\/wp\/v2\/pages\/661"}],"collection":[{"href":"https:\/\/webszh.uk-halle.de\/beonet\/index.php\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/webszh.uk-halle.de\/beonet\/index.php\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/webszh.uk-halle.de\/beonet\/index.php\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/webszh.uk-halle.de\/beonet\/index.php\/wp-json\/wp\/v2\/comments?post=661"}],"version-history":[{"count":72,"href":"https:\/\/webszh.uk-halle.de\/beonet\/index.php\/wp-json\/wp\/v2\/pages\/661\/revisions"}],"predecessor-version":[{"id":1302,"href":"https:\/\/webszh.uk-halle.de\/beonet\/index.php\/wp-json\/wp\/v2\/pages\/661\/revisions\/1302"}],"wp:attachment":[{"href":"https:\/\/webszh.uk-halle.de\/beonet\/index.php\/wp-json\/wp\/v2\/media?parent=661"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}