{"id":3335,"date":"2025-07-07T08:13:49","date_gmt":"2025-07-07T06:13:49","guid":{"rendered":"https:\/\/043arts.nl\/?post_type=praktijkinformatie&#038;p=3335"},"modified":"2025-07-07T08:17:56","modified_gmt":"2025-07-07T06:17:56","slug":"wijziging-doorgeven","status":"publish","type":"praktijkinformatie","link":"https:\/\/huisartsen.gcschalkwijk.nl\/fr\/praktijkinformatie\/wijziging-doorgeven\/","title":{"rendered":"Wijziging doorgeven"},"content":{"rendered":"<style>.elementor-3335 .elementor-element.elementor-element-3077fb4b{--display:flex;--min-height:140px;--flex-direction:row;--container-widget-width:calc( ( 1 - var( --container-widget-flex-grow ) ) * 100% );--container-widget-height:100%;--container-widget-flex-grow:1;--container-widget-align-self:stretch;--flex-wrap-mobile:wrap;--justify-content:center;--align-items:center;--gap:10px 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class=\"elementor-element elementor-element-3077fb4b e-flex e-con-boxed e-con e-parent\" data-id=\"3077fb4b\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;,&quot;jet_parallax_layout_list&quot;:[]}\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-68a7f10 elementor-widget elementor-widget-heading\" data-id=\"68a7f10\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Wijziging doorgeven<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-29583863 e-flex e-con-boxed e-con e-parent\" data-id=\"29583863\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;jet_parallax_layout_list&quot;:[]}\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div class=\"elementor-element elementor-element-4d260348 e-con-full e-flex e-con e-child\" data-id=\"4d260348\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;jet_parallax_layout_list&quot;:[]}\">\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-6999473 e-con-full e-flex e-con e-child\" data-id=\"6999473\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;jet_parallax_layout_list&quot;:[]}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-2139077f elementor-widget elementor-widget-heading\" data-id=\"2139077f\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Wijziging doorgeven<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-506f27a5 elementor-widget elementor-widget-text-editor\" data-id=\"506f27a5\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>Wilt u zich uitschrijven, iets wijzigen, een geboorte melden? 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style=\"\">\n\t\t\t\t<div class=\"elementor-element elementor-element-20b22f4 e-flex e-con-boxed e-con e-parent\" data-id=\"20b22f4\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;jet_parallax_layout_list&quot;:[]}\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-7ab8907 jedv-enabled--yes elementor-widget elementor-widget-jet-form-builder-form\" data-id=\"7ab8907\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"jet-form-builder-form.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<link rel='stylesheet' id='wp-block-library-css' href='https:\/\/huisartsen.gcschalkwijk.nl\/wp-includes\/css\/dist\/block-library\/style.min.css?ver=557a60ae955563b29e0bdbab89a9fe10' media='all' \/>\n<style id=\"jet-form-builder-3326-inline-css\"><\/style><form  class=\"jet-form-builder layout-column submit-type-ajax\" action=\"https:\/\/huisartsen.gcschalkwijk.nl\/fr\/wp-json\/wp\/v2\/praktijkinformatie\/3335\/?NaAUiG=QdewooC1QJ&amp;method=reload\" method=\"POST\" data-form-id=\"3326\" data-layout=\"column\" enctype=\"multipart\/form-data\" data-clear=\"1\" novalidate=\"null\" ssr_validation_method=\"rest\">\r\n<input type=\"hidden\" name=\"_jfb_current_render_states[]\" value=\"DEFAULT.STATE\" data-jfb-sync \/><input type=\"hidden\" class=\"jet-form-builder__field hidden-field\" name=\"_jet_engine_booking_form_id\" data-field-name=\"_jet_engine_booking_form_id\" value=\"3326\">\n<input type=\"hidden\" class=\"jet-form-builder__field hidden-field\" name=\"_jet_engine_refer\" data-field-name=\"_jet_engine_refer\" value=\"https:\/\/huisartsen.gcschalkwijk.nl\/fr\/wp-json\/wp\/v2\/praktijkinformatie\/3335\/\">\n<input type=\"hidden\" class=\"jet-form-builder__field hidden-field\" name=\"__queried_post_id\" data-field-name=\"__queried_post_id\" value=\"3335\">\n<div class=\"jet-form-builder-progress-pages jfb-progress-type--default jet-form-builder-progress-pages--global\" data-type=\"default\">\t<div class=\"jet-form-builder-progress-pages__item--wrapper active-page\" data-page=\"1\">\n\t\t<div class=\"jet-form-builder-progress-pages__item\">\n\t\t\t<div class=\"jet-form-builder-progress-pages__item--circle\">1<\/div>\n\t\t\t<div class=\"jet-form-builder-progress-pages__item--label\">Stap 1<\/div>\n\t\t<\/div>\n\t\t\t\t\t<div class=\"jet-form-builder-progress-pages__separator\"><\/div>\n\t\t\t<\/div>\n\t\t<div class=\"jet-form-builder-progress-pages__item--wrapper\" data-page=\"2\">\n\t\t<div class=\"jet-form-builder-progress-pages__item\">\n\t\t\t<div class=\"jet-form-builder-progress-pages__item--circle\">2<\/div>\n\t\t\t<div class=\"jet-form-builder-progress-pages__item--label\">Stap 2<\/div>\n\t\t<\/div>\n\t\t\t\t\t<div class=\"jet-form-builder-progress-pages__separator\"><\/div>\n\t\t\t<\/div>\n\t\t<div class=\"jet-form-builder-progress-pages__item--wrapper\" data-page=\"3\">\n\t\t<div class=\"jet-form-builder-progress-pages__item\">\n\t\t\t<div class=\"jet-form-builder-progress-pages__item--circle\">3<\/div>\n\t\t\t<div class=\"jet-form-builder-progress-pages__item--label\">Stap 3<\/div>\n\t\t<\/div>\n\t\t\t<\/div>\n\t<\/div><div class=\"jet-form-builder-page \" data-page=\"1\" data-page-offset=\"75\">\n\n\n<h2 class=\"wp-block-heading\">Pati\u00ebntgegevens<\/h2>\n\n\n<div  class=\"jet-form-builder-row field-type-select-field wp-block-jet-forms-select-field\">\n<div class=\"jet-form-builder__label\">\r\n<label class=\"jet-form-builder__label-text\" for=\"type_wijziging\">Type wijziging? <span class=\"jet-form-builder__required\">*<\/span><\/label><\/div><div class=\"jet-form-builder__field-wrap\">\n\t<select class=\"jet-form-builder__field select-field\" required=\"required\" name=\"type_wijziging\" data-field-name=\"type_wijziging\" id=\"type_wijziging\" data-jfb-sync=\"null\">\n\t\t<option value=\"\" disabled selected>Selecteer uw wijziging<\/option><option value=\"adres\" >Adres<\/option><option value=\"apotheek\" >Apotheek<\/option><option value=\"geboorte\" >Geboorte<\/option><option value=\"uitschrijven\" >Uitschrijven<\/option>\t<\/select>\n<\/div>\n<\/div>\n\n<div class=\"jet-form-builder__conditional \" data-jfb-conditional=\"[{&quot;operator&quot;:&quot;equal&quot;,&quot;value&quot;:&quot;geboorte&quot;,&quot;field&quot;:&quot;type_wijziging&quot;,&quot;use_preset&quot;:false}]\" data-jfb-func=\"{&quot;show&quot;:{&quot;dom&quot;:false}}\">\n\n<h4 class=\"wp-block-heading\" style=\"margin-top:1em;margin-bottom:1rem\">Vul hier de gegevens van de ouder in:<\/h4>\n\n<\/div>\n\n\n<div class=\"wp-block-columns is-layout-flex wp-container-core-columns-is-layout-28f84493 wp-block-columns-is-layout-flex\">\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:25%\"><div  class=\"jet-form-builder-row field-type-text-field\" >\n<div class=\"jet-form-builder__label\">\r\n<label class=\"jet-form-builder__label-text\" for=\"voorletters\">Voorletters <span class=\"jet-form-builder__required\">*<\/span><\/label><\/div><div class=\"jet-form-builder__field-wrap\">\n\t\t\t\t<input required=\"required\" name=\"voorletters\" id=\"voorletters\" type=\"text\" data-field-name=\"voorletters\" class=\"jet-form-builder__field text-field\" data-jfb-sync=\"null\" autocomplete=\"off_r61PBgHU\">\n\t\t\t\t\t<\/div>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:25%\"><div  class=\"jet-form-builder-row field-type-text-field\" >\n<div class=\"jet-form-builder__label\">\r\n<label class=\"jet-form-builder__label-text\" for=\"tussenvoegsel\">Tussenvoegsel<\/label><\/div><div class=\"jet-form-builder__field-wrap\">\n\t\t\t\t<input name=\"tussenvoegsel\" id=\"tussenvoegsel\" type=\"text\" data-field-name=\"tussenvoegsel\" class=\"jet-form-builder__field text-field\" data-jfb-sync=\"null\" autocomplete=\"off_ZTOSwbG2\">\n\t\t\t\t\t<\/div>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:50%\"><div  class=\"jet-form-builder-row field-type-text-field\" >\n<div class=\"jet-form-builder__label\">\r\n<label class=\"jet-form-builder__label-text\" for=\"achternaam\">Achternaam <span class=\"jet-form-builder__required\">*<\/span><\/label><\/div><div class=\"jet-form-builder__field-wrap\">\n\t\t\t\t<input required=\"required\" name=\"achternaam\" id=\"achternaam\" type=\"text\" data-field-name=\"achternaam\" class=\"jet-form-builder__field text-field\" data-jfb-sync=\"null\" autocomplete=\"off_FU3PET7N\">\n\t\t\t\t\t<\/div>\n<\/div><\/div>\n<\/div>\n\n\n<div  class=\"jet-form-builder-row field-type-date-field\" >\n<div class=\"jet-form-builder__label\">\r\n<label class=\"jet-form-builder__label-text\" for=\"geboortedatum\">Geboortedatum <span class=\"jet-form-builder__required\">*<\/span><\/label><\/div><input class=\"jet-form-builder__field date-field\" required=\"required\" name=\"geboortedatum\" type=\"date\" data-field-name=\"geboortedatum\" id=\"geboortedatum\" data-jfb-sync=\"null\">\n<\/div>\n\n<div  class=\"jet-form-builder-row field-type-select-field wp-block-jet-forms-select-field\">\n<div class=\"jet-form-builder__label\">\r\n<label class=\"jet-form-builder__label-text\" for=\"geslacht\">Geslacht <span class=\"jet-form-builder__required\">*<\/span><\/label><\/div><div class=\"jet-form-builder__field-wrap\">\n\t<select class=\"jet-form-builder__field select-field\" required=\"required\" name=\"geslacht\" data-field-name=\"geslacht\" id=\"geslacht\" data-jfb-sync=\"null\">\n\t\t<option value=\"\" disabled selected>Maak een keuze<\/option><option value=\"man\" >Man<\/option><option value=\"vrouw\" >Vrouw<\/option><option value=\"X\" >X<\/option>\t<\/select>\n<\/div>\n<\/div>\n\n<div  class=\"jet-form-builder-row field-type-text-field\" >\n<div class=\"jet-form-builder__label\">\r\n<label class=\"jet-form-builder__label-text\" for=\"mobiel_nummer\">Mobiel nummer <span class=\"jet-form-builder__required\">*<\/span><\/label><\/div><div class=\"jet-form-builder__field-wrap\">\n\t\t\t\t<input required=\"required\" name=\"mobiel_nummer\" id=\"mobiel_nummer\" type=\"text\" data-field-name=\"mobiel_nummer\" class=\"jet-form-builder__field text-field\" data-jfb-sync=\"null\" autocomplete=\"off_HQRvK0bI\">\n\t\t\t\t\t<\/div>\n<\/div>\n\n<div  class=\"jet-form-builder-row field-type-text-field\" >\n<div class=\"jet-form-builder__label\">\r\n<label class=\"jet-form-builder__label-text\" for=\"email\">E-mailadres <span class=\"jet-form-builder__required\">*<\/span><\/label><\/div><div class=\"jet-form-builder__field-wrap\">\n\t\t\t\t<input required=\"required\" name=\"email\" id=\"email\" type=\"text\" data-field-name=\"email\" class=\"jet-form-builder__field text-field\" data-jfb-sync=\"null\" autocomplete=\"off_CuHsfvdw\">\n\t\t\t\t\t<\/div>\n<\/div>\n\n\n<div class=\"wp-block-jet-engine-container jet-container jet-container--content-direction-horizontal jet-container--content-align-flex-start jet-container--content-justify-flex-end wp-block-jet-engine-container\"><div class=\"jet-container__overlay   \" style=\"opacity:0.5\"><\/div><div  class=\"jet-form-builder-row field-type-submit-field\" >\n\t<div data-type=\"next\" class=\"jet-form-builder__action-button-wrapper\">\n\t<button class=\"jet-form-builder__action-button jet-form-builder__next-page\" type=\"button\" data-jfb-conditional=\"[{&quot;page_state&quot;:&quot;active&quot;}]\" data-jfb-func=\"disable\">Volgende<\/button>\n\t<\/div>\n\t\n<\/div><\/div>\n\n\n<div class=\"jet-form-builder__next-page-wrap\">\n\t\t\t<\/div>\n<\/div>\n<div class=\"jet-form-builder-page jet-form-builder-page--hidden\" data-page=\"2\" data-page-offset=\"75\">\n\n<div class=\"jet-form-builder__conditional \" data-jfb-conditional=\"[{&quot;operator&quot;:&quot;equal&quot;,&quot;value&quot;:&quot;adres&quot;,&quot;field&quot;:&quot;type_wijziging&quot;,&quot;use_preset&quot;:false}]\" data-jfb-func=\"{&quot;show&quot;:{&quot;dom&quot;:true}}\">\n\n<h2 class=\"wp-block-heading\">Nieuwe adresgegevens<\/h2>\n\n\n<div  class=\"jet-form-builder-row field-type-text-field\" >\n<div class=\"jet-form-builder__label\">\r\n<label class=\"jet-form-builder__label-text\" for=\"adres_straat\">Straat <span class=\"jet-form-builder__required\">*<\/span><\/label><\/div><div class=\"jet-form-builder__field-wrap\">\n\t\t\t\t<input required=\"required\" name=\"adres_straat\" id=\"adres_straat\" type=\"text\" data-field-name=\"adres_straat\" class=\"jet-form-builder__field text-field\" data-jfb-sync=\"null\" autocomplete=\"off_ayOMA9B8\">\n\t\t\t\t\t<\/div>\n<\/div>\n\n<div  class=\"jet-form-builder-row field-type-text-field\" >\n<div class=\"jet-form-builder__label\">\r\n<label class=\"jet-form-builder__label-text\" for=\"adres_huisnummer\">Huisnummer <span class=\"jet-form-builder__required\">*<\/span><\/label><\/div><div class=\"jet-form-builder__field-wrap\">\n\t\t\t\t<input required=\"required\" name=\"adres_huisnummer\" id=\"adres_huisnummer\" type=\"text\" data-field-name=\"adres_huisnummer\" class=\"jet-form-builder__field text-field\" data-jfb-sync=\"null\" autocomplete=\"off_W1xTHAIX\">\n\t\t\t\t\t<\/div>\n<\/div>\n\n<div  class=\"jet-form-builder-row field-type-text-field\" >\n<div class=\"jet-form-builder__label\">\r\n<label class=\"jet-form-builder__label-text\" for=\"adres_toevoeging\">Toevoeging<\/label><\/div><div class=\"jet-form-builder__field-wrap\">\n\t\t\t\t<input name=\"adres_toevoeging\" id=\"adres_toevoeging\" type=\"text\" data-field-name=\"adres_toevoeging\" class=\"jet-form-builder__field text-field\" data-jfb-sync=\"null\" autocomplete=\"off_LWGtdxRB\">\n\t\t\t\t\t<\/div>\n<\/div>\n\n<div  class=\"jet-form-builder-row field-type-text-field\" >\n<div class=\"jet-form-builder__label\">\r\n<label class=\"jet-form-builder__label-text\" for=\"adres_postcode\">Postcode <span class=\"jet-form-builder__required\">*<\/span><\/label><\/div><div class=\"jet-form-builder__field-wrap\">\n\t\t\t\t<input required=\"required\" name=\"adres_postcode\" id=\"adres_postcode\" type=\"text\" data-field-name=\"adres_postcode\" class=\"jet-form-builder__field text-field\" data-jfb-sync=\"null\" autocomplete=\"off_5sZM8WaK\">\n\t\t\t\t\t<\/div>\n<\/div>\n\n<div  class=\"jet-form-builder-row field-type-text-field\" >\n<div class=\"jet-form-builder__label\">\r\n<label class=\"jet-form-builder__label-text\" for=\"adres_plaats\">Plaats <span class=\"jet-form-builder__required\">*<\/span><\/label><\/div><div class=\"jet-form-builder__field-wrap\">\n\t\t\t\t<input required=\"required\" name=\"adres_plaats\" id=\"adres_plaats\" type=\"text\" data-field-name=\"adres_plaats\" class=\"jet-form-builder__field text-field\" data-jfb-sync=\"null\" autocomplete=\"off_ihpCLKJe\">\n\t\t\t\t\t<\/div>\n<\/div>\n\n<div  class=\"jet-form-builder-row field-type-repeater-field\" >\n<div class=\"jet-form-builder__label\">\r\n<div class=\"jet-form-builder__label-text\">Meerdere woonverbandleden?<\/div><\/div><div class=\"jet-form-builder__field-wrap\"><div data-repeater=\"1\" data-field-name=\"adres_meerdere_woonverbandleden\" name=\"adres_meerdere_woonverbandleden\"  class=\"jet-form-builder-repeater jet-form-builder__field\" data-jfb-sync=\"null\">\n<template class=\"jet-form-builder-repeater__initial\"><div class=\"jet-form-builder-repeater__row\" data-repeater-row=\"1\"><div class=\"jet-form-builder-repeater__row-fields\">\n<div  class=\"jet-form-builder-row field-type-text-field\" >\n<div class=\"jet-form-builder__label\">\r\n<label class=\"jet-form-builder__label-text\" for=\"adres_meerdere_woonverbandleden___i___adres_meerdere_woonverbandleden_voorletters\">Voorletters <span class=\"jet-form-builder__required\">*<\/span><\/label><\/div><div class=\"jet-form-builder__field-wrap\">\n\t\t\t\t<input required=\"required\" name=\"adres_meerdere_woonverbandleden[__i__][adres_meerdere_woonverbandleden_voorletters]\" id=\"adres_meerdere_woonverbandleden___i___adres_meerdere_woonverbandleden_voorletters\" type=\"text\" data-field-name=\"adres_meerdere_woonverbandleden_voorletters\" class=\"jet-form-builder__field text-field\" data-jfb-sync=\"null\" autocomplete=\"off_GwOaWVtP\">\n\t\t\t\t\t<\/div>\n<\/div>\n\n<div  class=\"jet-form-builder-row field-type-text-field\" >\n<div class=\"jet-form-builder__label\">\r\n<label class=\"jet-form-builder__label-text\" for=\"adres_meerdere_woonverbandleden___i___adres_meerdere_woonverbandleden_tussenvoegsel\">Tussenvoegsel<\/label><\/div><div class=\"jet-form-builder__field-wrap\">\n\t\t\t\t<input name=\"adres_meerdere_woonverbandleden[__i__][adres_meerdere_woonverbandleden_tussenvoegsel]\" id=\"adres_meerdere_woonverbandleden___i___adres_meerdere_woonverbandleden_tussenvoegsel\" type=\"text\" data-field-name=\"adres_meerdere_woonverbandleden_tussenvoegsel\" class=\"jet-form-builder__field text-field\" data-jfb-sync=\"null\" autocomplete=\"off_ERMA8l4I\">\n\t\t\t\t\t<\/div>\n<\/div>\n\n<div  class=\"jet-form-builder-row field-type-text-field\" >\n<div class=\"jet-form-builder__label\">\r\n<label class=\"jet-form-builder__label-text\" for=\"adres_meerdere_woonverbandleden___i___adres_meerdere_woonverbandleden_achternaam\">Achternaam <span class=\"jet-form-builder__required\">*<\/span><\/label><\/div><div class=\"jet-form-builder__field-wrap\">\n\t\t\t\t<input required=\"required\" name=\"adres_meerdere_woonverbandleden[__i__][adres_meerdere_woonverbandleden_achternaam]\" id=\"adres_meerdere_woonverbandleden___i___adres_meerdere_woonverbandleden_achternaam\" type=\"text\" data-field-name=\"adres_meerdere_woonverbandleden_achternaam\" class=\"jet-form-builder__field text-field\" data-jfb-sync=\"null\" autocomplete=\"off_yVOvtwmW\">\n\t\t\t\t\t<\/div>\n<\/div>\n\n<div  class=\"jet-form-builder-row field-type-date-field\" >\n<div class=\"jet-form-builder__label\">\r\n<label class=\"jet-form-builder__label-text\" for=\"adres_meerdere_woonverbandleden___i___adres_meerdere_woonverbandleden_geboortedatum\">Geboortedatum <span class=\"jet-form-builder__required\">*<\/span><\/label><\/div><input class=\"jet-form-builder__field date-field\" required=\"required\" name=\"adres_meerdere_woonverbandleden[__i__][adres_meerdere_woonverbandleden_geboortedatum]\" type=\"date\" data-field-name=\"adres_meerdere_woonverbandleden_geboortedatum\" id=\"adres_meerdere_woonverbandleden___i___adres_meerdere_woonverbandleden_geboortedatum\" data-jfb-sync=\"null\">\n<\/div>\n\n<div  class=\"jet-form-builder-row field-type-select-field wp-block-jet-forms-select-field\">\n<div class=\"jet-form-builder__label\">\r\n<label class=\"jet-form-builder__label-text\" for=\"adres_meerdere_woonverbandleden___i___adres_meerdere_woonverbandleden_geslacht\">Geslacht <span class=\"jet-form-builder__required\">*<\/span><\/label><\/div><div class=\"jet-form-builder__field-wrap\">\n\t<select class=\"jet-form-builder__field select-field\" required=\"required\" name=\"adres_meerdere_woonverbandleden[__i__][adres_meerdere_woonverbandleden_geslacht]\" data-field-name=\"adres_meerdere_woonverbandleden_geslacht\" id=\"adres_meerdere_woonverbandleden___i___adres_meerdere_woonverbandleden_geslacht\" data-jfb-sync=\"null\">\n\t\t<option value=\"\" disabled selected>Maak een keuze<\/option><option value=\"man\" >Man<\/option><option value=\"vrouw\" >Vrouw<\/option><option value=\"X\" >X<\/option>\t<\/select>\n<\/div>\n<\/div>\n<\/div><div class=\"jet-form-builder-repeater__row-remove\"><button type=\"button\" class=\"jet-form-builder-repeater__remove\">&times;<\/button><\/div><\/div><\/template>\n<div class=\"jet-form-builder-repeater__items\"><\/div><div class=\"jet-form-builder-repeater__actions\">\n                <button type=\"button\" class=\"jet-form-builder-repeater__new\">Toevoegen<\/button>\n                <\/div><\/div><\/div>\n<\/div>\n<\/div>\n\n<div class=\"jet-form-builder__conditional \" data-jfb-conditional=\"[{&quot;operator&quot;:&quot;equal&quot;,&quot;value&quot;:&quot;apotheek&quot;,&quot;field&quot;:&quot;type_wijziging&quot;,&quot;use_preset&quot;:false}]\" data-jfb-func=\"{&quot;show&quot;:{&quot;dom&quot;:true}}\">\n\n<h2 class=\"wp-block-heading\">Gegevens nieuwe apotheek<\/h2>\n\n\n<div  class=\"jet-form-builder-row field-type-text-field\" >\n<div class=\"jet-form-builder__label\">\r\n<label class=\"jet-form-builder__label-text\" for=\"apotheek_naam_apotheek\">Naam Apotheek <span class=\"jet-form-builder__required\">*<\/span><\/label><\/div><div class=\"jet-form-builder__field-wrap\">\n\t\t\t\t<input required=\"required\" name=\"apotheek_naam_apotheek\" id=\"apotheek_naam_apotheek\" type=\"text\" data-field-name=\"apotheek_naam_apotheek\" class=\"jet-form-builder__field text-field\" data-jfb-sync=\"null\" autocomplete=\"off_z9fMyPCe\">\n\t\t\t\t\t<\/div>\n<\/div>\n\n<div  class=\"jet-form-builder-row field-type-text-field\" >\n<div class=\"jet-form-builder__label\">\r\n<label class=\"jet-form-builder__label-text\" for=\"apotheek_plaatsnaam_apotheek\">Plaatsnaam Apotheek <span class=\"jet-form-builder__required\">*<\/span><\/label><\/div><div class=\"jet-form-builder__field-wrap\">\n\t\t\t\t<input required=\"required\" name=\"apotheek_plaatsnaam_apotheek\" id=\"apotheek_plaatsnaam_apotheek\" type=\"text\" data-field-name=\"apotheek_plaatsnaam_apotheek\" class=\"jet-form-builder__field text-field\" data-jfb-sync=\"null\" autocomplete=\"off_VDfa68uQ\">\n\t\t\t\t\t<\/div>\n<\/div>\n<\/div>\n\n<div class=\"jet-form-builder__conditional \" data-jfb-conditional=\"[{&quot;operator&quot;:&quot;equal&quot;,&quot;value&quot;:&quot;geboorte&quot;,&quot;field&quot;:&quot;type_wijziging&quot;,&quot;use_preset&quot;:false}]\" data-jfb-func=\"{&quot;show&quot;:{&quot;dom&quot;:true}}\">\n\n<h2 class=\"wp-block-heading\">Gegevens van de pasgeborene(n)<\/h2>\n\n\n<div  class=\"jet-form-builder-row field-type-repeater-field\" >\n<div class=\"jet-form-builder__label\">\r\n<div class=\"jet-form-builder__label-text\">Pasgeborene(n)<\/div><\/div><div class=\"jet-form-builder__field-wrap\"><div data-repeater=\"1\" data-field-name=\"pasgeborenen\" name=\"pasgeborenen\"  class=\"jet-form-builder-repeater jet-form-builder__field item-on-load\" data-jfb-sync=\"null\">\n<template class=\"jet-form-builder-repeater__initial\"><div class=\"jet-form-builder-repeater__row\" data-repeater-row=\"1\"><div class=\"jet-form-builder-repeater__row-fields\">\n<div  class=\"jet-form-builder-row field-type-date-field\" >\n<div class=\"jet-form-builder__label\">\r\n<label class=\"jet-form-builder__label-text\" for=\"pasgeborenen___i___geboorte_datum\">Geboortedatum <span class=\"jet-form-builder__required\">*<\/span><\/label><\/div><input class=\"jet-form-builder__field date-field\" required=\"required\" name=\"pasgeborenen[__i__][geboorte_datum]\" type=\"date\" data-field-name=\"geboorte_datum\" id=\"pasgeborenen___i___geboorte_datum\" data-jfb-sync=\"null\">\n<\/div>\n\n<div  class=\"jet-form-builder-row field-type-text-field\" >\n<div class=\"jet-form-builder__label\">\r\n<label class=\"jet-form-builder__label-text\" for=\"pasgeborenen___i___geboorte_voorletters\">Voorletters <span class=\"jet-form-builder__required\">*<\/span><\/label><\/div><div class=\"jet-form-builder__field-wrap\">\n\t\t\t\t<input required=\"required\" name=\"pasgeborenen[__i__][geboorte_voorletters]\" id=\"pasgeborenen___i___geboorte_voorletters\" type=\"text\" data-field-name=\"geboorte_voorletters\" class=\"jet-form-builder__field text-field\" data-jfb-sync=\"null\" autocomplete=\"off_qSgpyDhr\">\n\t\t\t\t\t<\/div>\n<\/div>\n\n<div  class=\"jet-form-builder-row field-type-text-field\" >\n<div class=\"jet-form-builder__label\">\r\n<label class=\"jet-form-builder__label-text\" for=\"pasgeborenen___i___geboorte_voornaam\">Voornaam <span class=\"jet-form-builder__required\">*<\/span><\/label><\/div><div class=\"jet-form-builder__field-wrap\">\n\t\t\t\t<input required=\"required\" name=\"pasgeborenen[__i__][geboorte_voornaam]\" id=\"pasgeborenen___i___geboorte_voornaam\" type=\"text\" data-field-name=\"geboorte_voornaam\" class=\"jet-form-builder__field text-field\" data-jfb-sync=\"null\" autocomplete=\"off_ejOCYkUv\">\n\t\t\t\t\t<\/div>\n<\/div>\n\n<div  class=\"jet-form-builder-row field-type-text-field\" >\n<div class=\"jet-form-builder__label\">\r\n<label class=\"jet-form-builder__label-text\" for=\"pasgeborenen___i___geboorte_tussenvoegsel\">Tussenvoegsel<\/label><\/div><div class=\"jet-form-builder__field-wrap\">\n\t\t\t\t<input name=\"pasgeborenen[__i__][geboorte_tussenvoegsel]\" id=\"pasgeborenen___i___geboorte_tussenvoegsel\" type=\"text\" data-field-name=\"geboorte_tussenvoegsel\" class=\"jet-form-builder__field text-field\" data-jfb-sync=\"null\" autocomplete=\"off_7VYbLxHM\">\n\t\t\t\t\t<\/div>\n<\/div>\n\n<div  class=\"jet-form-builder-row field-type-text-field\" >\n<div class=\"jet-form-builder__label\">\r\n<label class=\"jet-form-builder__label-text\" for=\"pasgeborenen___i___geboorte_achternaam\">Achternaam <span class=\"jet-form-builder__required\">*<\/span><\/label><\/div><div class=\"jet-form-builder__field-wrap\">\n\t\t\t\t<input required=\"required\" name=\"pasgeborenen[__i__][geboorte_achternaam]\" id=\"pasgeborenen___i___geboorte_achternaam\" type=\"text\" data-field-name=\"geboorte_achternaam\" class=\"jet-form-builder__field text-field\" data-jfb-sync=\"null\" autocomplete=\"off_sGKNVieQ\">\n\t\t\t\t\t<\/div>\n<\/div>\n<\/div><div class=\"jet-form-builder-repeater__row-remove\"><button type=\"button\" class=\"jet-form-builder-repeater__remove\">&times;<\/button><\/div><\/div><\/template>\n<div class=\"jet-form-builder-repeater__items\"><\/div><div class=\"jet-form-builder-repeater__actions\">\n                <button type=\"button\" class=\"jet-form-builder-repeater__new\">Toevoegen<\/button>\n                <\/div><\/div><\/div>\n<\/div>\n<\/div>\n\n<div class=\"jet-form-builder__conditional \" data-jfb-conditional=\"[{&quot;operator&quot;:&quot;equal&quot;,&quot;value&quot;:&quot;uitschrijven&quot;,&quot;field&quot;:&quot;type_wijziging&quot;,&quot;use_preset&quot;:false}]\" data-jfb-func=\"{&quot;show&quot;:{&quot;dom&quot;:true}}\">\n\n<h2 class=\"wp-block-heading\">Gegevens nieuwe huisarts<\/h2>\n\n\n<div  class=\"jet-form-builder-row field-type-text-field\" >\n<div class=\"jet-form-builder__label\">\r\n<label class=\"jet-form-builder__label-text\" for=\"uitschrijven_woonplaats_nieuwe_huisarts\">Woonplaats nieuwe huisarts <span class=\"jet-form-builder__required\">*<\/span><\/label><\/div><div class=\"jet-form-builder__field-wrap\">\n\t\t\t\t<input required=\"required\" name=\"uitschrijven_woonplaats_nieuwe_huisarts\" id=\"uitschrijven_woonplaats_nieuwe_huisarts\" type=\"text\" data-field-name=\"uitschrijven_woonplaats_nieuwe_huisarts\" class=\"jet-form-builder__field text-field\" data-jfb-sync=\"null\" autocomplete=\"off_YRzxs6d1\">\n\t\t\t\t\t<\/div>\n<\/div>\n\n<div  class=\"jet-form-builder-row field-type-text-field\" >\n<div class=\"jet-form-builder__label\">\r\n<label class=\"jet-form-builder__label-text\" for=\"uitschrijven_nieuwe_huisarts\">Nieuwe huisarts <span class=\"jet-form-builder__required\">*<\/span><\/label><\/div><div class=\"jet-form-builder__field-wrap\">\n\t\t\t\t<input required=\"required\" name=\"uitschrijven_nieuwe_huisarts\" id=\"uitschrijven_nieuwe_huisarts\" type=\"text\" data-field-name=\"uitschrijven_nieuwe_huisarts\" class=\"jet-form-builder__field text-field\" data-jfb-sync=\"null\" autocomplete=\"off_jeoiKAhO\">\n\t\t\t\t\t<\/div>\n<\/div>\n\n<div  class=\"jet-form-builder-row field-type-repeater-field\" >\n<div class=\"jet-form-builder__label\">\r\n<div class=\"jet-form-builder__label-text\">Meerdere woonverbandleden?<\/div><\/div><div class=\"jet-form-builder__field-wrap\"><div data-repeater=\"1\" data-field-name=\"uitschrijven_meerdere_woonverbandleden\" name=\"uitschrijven_meerdere_woonverbandleden\"  class=\"jet-form-builder-repeater jet-form-builder__field\" data-jfb-sync=\"null\">\n<template class=\"jet-form-builder-repeater__initial\"><div class=\"jet-form-builder-repeater__row\" data-repeater-row=\"1\"><div class=\"jet-form-builder-repeater__row-fields\">\n<div  class=\"jet-form-builder-row field-type-text-field\" >\n<div class=\"jet-form-builder__label\">\r\n<label class=\"jet-form-builder__label-text\" for=\"uitschrijven_meerdere_woonverbandleden___i___uitschrijven_meerdere_woonverbandleden_voorletters\">Voorletters <span class=\"jet-form-builder__required\">*<\/span><\/label><\/div><div class=\"jet-form-builder__field-wrap\">\n\t\t\t\t<input required=\"required\" name=\"uitschrijven_meerdere_woonverbandleden[__i__][uitschrijven_meerdere_woonverbandleden_voorletters]\" id=\"uitschrijven_meerdere_woonverbandleden___i___uitschrijven_meerdere_woonverbandleden_voorletters\" type=\"text\" data-field-name=\"uitschrijven_meerdere_woonverbandleden_voorletters\" class=\"jet-form-builder__field text-field\" data-jfb-sync=\"null\" autocomplete=\"off_ozpIjTKu\">\n\t\t\t\t\t<\/div>\n<\/div>\n\n<div  class=\"jet-form-builder-row field-type-text-field\" >\n<div class=\"jet-form-builder__label\">\r\n<label class=\"jet-form-builder__label-text\" for=\"uitschrijven_meerdere_woonverbandleden___i___uitschrijven_meerdere_woonverbandleden_tussenvoegsel\">Tussenvoegsel<\/label><\/div><div class=\"jet-form-builder__field-wrap\">\n\t\t\t\t<input name=\"uitschrijven_meerdere_woonverbandleden[__i__][uitschrijven_meerdere_woonverbandleden_tussenvoegsel]\" id=\"uitschrijven_meerdere_woonverbandleden___i___uitschrijven_meerdere_woonverbandleden_tussenvoegsel\" type=\"text\" data-field-name=\"uitschrijven_meerdere_woonverbandleden_tussenvoegsel\" class=\"jet-form-builder__field text-field\" data-jfb-sync=\"null\" autocomplete=\"off_3ZSWcMR4\">\n\t\t\t\t\t<\/div>\n<\/div>\n\n<div  class=\"jet-form-builder-row field-type-text-field\" >\n<div class=\"jet-form-builder__label\">\r\n<label class=\"jet-form-builder__label-text\" for=\"uitschrijven_meerdere_woonverbandleden___i___uitschrijven_meerdere_woonverbandleden_achternaam\">Achternaam <span class=\"jet-form-builder__required\">*<\/span><\/label><\/div><div class=\"jet-form-builder__field-wrap\">\n\t\t\t\t<input required=\"required\" name=\"uitschrijven_meerdere_woonverbandleden[__i__][uitschrijven_meerdere_woonverbandleden_achternaam]\" id=\"uitschrijven_meerdere_woonverbandleden___i___uitschrijven_meerdere_woonverbandleden_achternaam\" type=\"text\" data-field-name=\"uitschrijven_meerdere_woonverbandleden_achternaam\" class=\"jet-form-builder__field text-field\" data-jfb-sync=\"null\" autocomplete=\"off_or1Zi5sE\">\n\t\t\t\t\t<\/div>\n<\/div>\n\n<div  class=\"jet-form-builder-row field-type-date-field\" >\n<div class=\"jet-form-builder__label\">\r\n<label class=\"jet-form-builder__label-text\" for=\"uitschrijven_meerdere_woonverbandleden___i___uitschrijven_meerdere_woonverbandleden_geboortedatum\">Geboortedatum <span class=\"jet-form-builder__required\">*<\/span><\/label><\/div><input class=\"jet-form-builder__field date-field\" required=\"required\" name=\"uitschrijven_meerdere_woonverbandleden[__i__][uitschrijven_meerdere_woonverbandleden_geboortedatum]\" type=\"date\" data-field-name=\"uitschrijven_meerdere_woonverbandleden_geboortedatum\" id=\"uitschrijven_meerdere_woonverbandleden___i___uitschrijven_meerdere_woonverbandleden_geboortedatum\" data-jfb-sync=\"null\">\n<\/div>\n\n<div  class=\"jet-form-builder-row field-type-select-field wp-block-jet-forms-select-field\">\n<div class=\"jet-form-builder__label\">\r\n<label class=\"jet-form-builder__label-text\" for=\"uitschrijven_meerdere_woonverbandleden___i___uitschrijven_meerdere_woonverbandleden_geslacht\">Geslacht <span class=\"jet-form-builder__required\">*<\/span><\/label><\/div><div class=\"jet-form-builder__field-wrap\">\n\t<select class=\"jet-form-builder__field select-field\" required=\"required\" name=\"uitschrijven_meerdere_woonverbandleden[__i__][uitschrijven_meerdere_woonverbandleden_geslacht]\" data-field-name=\"uitschrijven_meerdere_woonverbandleden_geslacht\" id=\"uitschrijven_meerdere_woonverbandleden___i___uitschrijven_meerdere_woonverbandleden_geslacht\" data-jfb-sync=\"null\">\n\t\t<option value=\"\" disabled selected>Maak een keuze<\/option><option value=\"man\" >Man<\/option><option value=\"vrouw\" >Vrouw<\/option><option value=\"X\" >X<\/option>\t<\/select>\n<\/div>\n<\/div>\n<\/div><div class=\"jet-form-builder-repeater__row-remove\"><button type=\"button\" class=\"jet-form-builder-repeater__remove\">&times;<\/button><\/div><\/div><\/template>\n<div class=\"jet-form-builder-repeater__items\"><\/div><div class=\"jet-form-builder-repeater__actions\">\n                <button type=\"button\" class=\"jet-form-builder-repeater__new\">Toevoegen<\/button>\n                <\/div><\/div><\/div>\n<\/div>\n\n<div  class=\"jet-form-builder-row field-type-date-field\" >\n<div class=\"jet-form-builder__label\">\r\n<label class=\"jet-form-builder__label-text\" for=\"gewenste_uitschrijfdatum\">Gewenste uitschrijfdatum <span class=\"jet-form-builder__required\">*<\/span><\/label><\/div><input class=\"jet-form-builder__field date-field\" required=\"required\" name=\"gewenste_uitschrijfdatum\" type=\"date\" data-field-name=\"gewenste_uitschrijfdatum\" id=\"gewenste_uitschrijfdatum\" data-jfb-sync=\"null\">\n<\/div>\n\n<div  class=\"jet-form-builder-row field-type-radio-field wp-block-jet-forms-radio-field\">\n<div class=\"jet-form-builder__label\">\r\n<div class=\"jet-form-builder__label-text\">Ik ga akkoord met het versturen van mijn dossier naar mijn nieuwe huisarts <span class=\"jet-form-builder__required\">*<\/span><\/div><\/div><div class=\"jet-form-builder__fields-group checkradio-wrap\" data-jfb-sync><div class=\"jet-form-builder__field-wrap radio-wrap checkradio-wrap\"><label class=\"jet-form-builder__field-label for-radio\">\n<input type=\"radio\" name=\"toestemming_dossier_naar_nieuwe_huisarts_copy\" value=\"Ja\" data-field-name=\"toestemming_dossier_naar_nieuwe_huisarts_copy\"  class=\"jet-form-builder__field radio-field checkradio-field\" required=\"required\"><span>Ja<\/span><\/label><\/div><div class=\"jet-form-builder__field-wrap radio-wrap checkradio-wrap\"><label class=\"jet-form-builder__field-label for-radio\">\n<input type=\"radio\" name=\"toestemming_dossier_naar_nieuwe_huisarts_copy\" value=\"Nee\" data-field-name=\"toestemming_dossier_naar_nieuwe_huisarts_copy\"  class=\"jet-form-builder__field radio-field checkradio-field\" required=\"required\"><span>Nee<\/span><\/label><\/div><\/div>\n<\/div>\n<\/div>\n\n\n<div class=\"wp-block-jet-engine-container jet-container jet-container--content-direction-horizontal jet-container--content-align-flex-start jet-container--content-justify-space-between wp-block-jet-engine-container\"><div class=\"jet-container__overlay   \" style=\"opacity:0.5\"><\/div><div  class=\"jet-form-builder-row field-type-submit-field\" >\n\t<div data-type=\"prev\" class=\"jet-form-builder__action-button-wrapper\">\n\t<button class=\"jet-form-builder__action-button jet-form-builder__prev-page\" type=\"button\">Vorige<\/button>\n\t<\/div>\n\t\n<\/div>\n\n<div  class=\"jet-form-builder-row field-type-submit-field\" >\n\t<div data-type=\"next\" class=\"jet-form-builder__action-button-wrapper\">\n\t<button class=\"jet-form-builder__action-button jet-form-builder__next-page\" type=\"button\" data-jfb-conditional=\"[{&quot;page_state&quot;:&quot;active&quot;}]\" data-jfb-func=\"disable\">Volgende<\/button>\n\t<\/div>\n\t\n<\/div><\/div>\n\n\n<div class=\"jet-form-builder__next-page-wrap\">\n\t\t\t<\/div>\n<\/div>\n<div class=\"jet-form-builder-page jet-form-builder-page--hidden\" data-page=\"3\" data-page-offset=\"75\">\n\n\n<h2 class=\"wp-block-heading\">Wijziging doorgeven<\/h2>\n\n\n<div  class=\"jet-form-builder-row field-type-textarea-field\" >\n<div class=\"jet-form-builder__label\">\r\n<label class=\"jet-form-builder__label-text\" for=\"opmerkingen\">Belangrijke info \/ Opmerkingen<\/label><\/div><div class=\"jet-form-builder__field-wrap\">\n\t\t<textarea class=\"jet-form-builder__field textarea-field\" name=\"opmerkingen\" data-field-name=\"opmerkingen\" id=\"opmerkingen\" data-jfb-sync=\"null\"><\/textarea>\n\t<\/div>\n<\/div>\n\n\n<div class=\"wp-block-jet-engine-container jet-container jet-container--content-direction-horizontal jet-container--content-align-flex-start jet-container--content-justify-space-between wp-block-jet-engine-container\"><div class=\"jet-container__overlay   \" style=\"opacity:0.5\"><\/div><div  class=\"jet-form-builder-row field-type-submit-field\" >\n\t<div data-type=\"prev\" class=\"jet-form-builder__action-button-wrapper\">\n\t<button class=\"jet-form-builder__action-button jet-form-builder__prev-page\" type=\"button\">Vorige<\/button>\n\t<\/div>\n\t\n<\/div>\n\n<input type=\"hidden\" class=\"captcha-token\" name=\"_captcha_token\" value=\"\"\/><div  class=\"jet-form-builder-row field-type-submit-field\" >\n\t<div data-type=\"submit\" class=\"jet-form-builder__action-button-wrapper jet-form-builder__submit-wrap\">\n\t<button class=\"jet-form-builder__action-button jet-form-builder__submit submit-type-ajax\" type=\"submit\">Wijziging doorgeven<\/button>\n\t<\/div>\n\t\n<\/div><\/div>\n\n\n<\/div>\t<div class=\"jet-form-builder-messages-wrap\" data-form-id=\"3326\"><\/div>\n<\/form>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t","protected":false},"template":"elementor_header_footer","zichtbaarheid":[],"class_list":["post-3335","praktijkinformatie","type-praktijkinformatie","status-publish","has-post-thumbnail","hentry"],"_links":{"self":[{"href":"https:\/\/huisartsen.gcschalkwijk.nl\/fr\/wp-json\/wp\/v2\/praktijkinformatie\/3335","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/huisartsen.gcschalkwijk.nl\/fr\/wp-json\/wp\/v2\/praktijkinformatie"}],"about":[{"href":"https:\/\/huisartsen.gcschalkwijk.nl\/fr\/wp-json\/wp\/v2\/types\/praktijkinformatie"}],"version-history":[{"count":5,"href":"https:\/\/huisartsen.gcschalkwijk.nl\/fr\/wp-json\/wp\/v2\/praktijkinformatie\/3335\/revisions"}],"predecessor-version":[{"id":3395,"href":"https:\/\/huisartsen.gcschalkwijk.nl\/fr\/wp-json\/wp\/v2\/praktijkinformatie\/3335\/revisions\/3395"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/huisartsen.gcschalkwijk.nl\/fr\/wp-json\/wp\/v2\/media\/1041"}],"wp:attachment":[{"href":"https:\/\/huisartsen.gcschalkwijk.nl\/fr\/wp-json\/wp\/v2\/media?parent=3335"}],"wp:term":[{"taxonomy":"zichtbaarheid","embeddable":true,"href":"https:\/\/huisartsen.gcschalkwijk.nl\/fr\/wp-json\/wp\/v2\/zichtbaarheid?post=3335"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}