{"id":2066,"date":"2026-03-20T08:38:23","date_gmt":"2026-03-20T08:38:23","guid":{"rendered":"https:\/\/weightconsult.nl\/?page_id=2066"},"modified":"2026-09-11T09:15:09","modified_gmt":"2026-09-11T09:15:09","slug":"questionnaire","status":"publish","type":"page","link":"https:\/\/weightconsult.nl\/en\/vragenlijst\/","title":{"rendered":"Questionnaire"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"2066\" class=\"elementor elementor-2066\" data-elementor-post-type=\"page\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-8fe7b78 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"8fe7b78\" data-element_type=\"section\" data-e-type=\"section\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\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-ab5cf7f\" data-id=\"ab5cf7f\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-43f79ce elementor-widget elementor-widget-heading\" data-id=\"43f79ce\" 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<h1 class=\"elementor-heading-title elementor-size-default\">Vul alle gegevens in voor behandelplan<\/h1>\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<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-d695d99 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"d695d99\" data-element_type=\"section\" data-e-type=\"section\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\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-50 elementor-top-column elementor-element elementor-element-edfb53b\" data-id=\"edfb53b\" data-element_type=\"column\" data-e-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<div class=\"elementor-element elementor-element-3b2fd7c elementor-widget-tablet__width-initial elementor-widget elementor-widget-text-editor\" data-id=\"3b2fd7c\" 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><strong>Start vandaag nog!<\/strong>\u00a0<br \/>Vul je gegevens in en de medische vragen. Onze specialisten beoordelen direct of je kunt starten met een behandeltraject, je hoort binnen 24-uur of je kan beginnen en ontvangt als eerst een betaalverzoek. Daarna volgt het online consult en levering van de medicatie.<\/p><p>\u2714 100% vrijblijvend<br \/>\u2714 Binnen 24 uur in je inbox<br \/>\u2714 Beoordeeld door een BIG-geregistreerde arts<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<p class=\"e-paragraph-base e-default-p\" data-interaction-id=\"5c8399a\" data-e-type=\"widget\" data-id=\"5c8399a\">Type your paragraph here<\/p>\n\t\t\t\t<div class=\"elementor-element elementor-element-ff4f58a elementor-button-align-start elementor-widget-tablet__width-initial elementor-widget elementor-widget-form\" data-id=\"ff4f58a\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;step_next_label&quot;:&quot;Volgende&quot;,&quot;step_previous_label&quot;:&quot;Vorige&quot;,&quot;button_width&quot;:&quot;100&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\t\t<form class=\"elementor-form\" method=\"post\" name=\"Vragenlijst\" aria-label=\"Vragenlijst\">\n\t\t\t<input type=\"hidden\" name=\"post_id\" value=\"2066\"\/>\n\t\t\t<input type=\"hidden\" name=\"form_id\" value=\"ff4f58a\"\/>\n\t\t\t<input type=\"hidden\" name=\"referer_title\" value=\"Vragenlijst - WeightConsult\" \/>\n\n\t\t\t\t\t\t\t<input type=\"hidden\" name=\"queried_id\" value=\"2066\"\/>\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-step elementor-field-group elementor-column elementor-field-group-field_c6023a4 elementor-col-100\">\n\t\t\t\t\t\t\t<div class=\"e-field-step elementor-hidden\" data-label=\"Gegevens\" data-previousButton=\"\" data-nextButton=\"\" data-iconUrl=\"\" data-iconLibrary=\"\" data-icon=\"\" ><\/div>\n\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-select elementor-field-group elementor-column elementor-field-group-field_e2c7f2a elementor-col-100 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_e2c7f2a\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tGeslacht\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field elementor-select-wrapper remove-before \">\n\t\t\t<div class=\"select-caret-down-wrapper\">\n\t\t\t\t<i aria-hidden=\"true\" class=\"eicon-caret-down\"><\/i>\t\t\t<\/div>\n\t\t\t<select name=\"form_fields[field_e2c7f2a]\" id=\"form-field-field_e2c7f2a\" class=\"elementor-field-textual elementor-size-sm\" required=\"required\">\n\t\t\t\t\t\t\t\t\t<option value=\"\">Maak een keuze<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"man\">Man<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"vrouw\">Vrouw<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"anders\">Anders \/ non-binair<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"geen_opgave\">Zeg ik liever niet<\/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_6ae88fe elementor-col-50 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_6ae88fe\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tInitialen\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_6ae88fe]\" id=\"form-field-field_6ae88fe\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"A.J\" required=\"required\">\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_fda01e5 elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_fda01e5\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tTussenv.\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_fda01e5]\" id=\"form-field-field_fda01e5\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"van\">\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-name elementor-col-100 elementor-field-required elementor-mark-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\tAchternaam\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-sm  elementor-field-textual\" placeholder=\"Janssen\" required=\"required\">\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-email elementor-col-100 elementor-field-required elementor-mark-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\tTelefoonnummer\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[email]\" id=\"form-field-email\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"06123456789\" required=\"required\" pattern=\"[0-9()#&amp;+*-=.]+\" title=\"Alleen nummers en telefoontekens (#, -, *, enz.) worden geaccepteerd.\">\n\n\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-field_450f72c elementor-col-100 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_450f72c\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tE-mailadres\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[field_450f72c]\" id=\"form-field-field_450f72c\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" required=\"required\">\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-number elementor-field-group elementor-column elementor-field-group-field_1002330 elementor-col-50 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_1002330\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tGewicht (kg)\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t<input type=\"number\" name=\"form_fields[field_1002330]\" id=\"form-field-field_1002330\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"94.5\" required=\"required\" min=\"\" max=\"\" >\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-number elementor-field-group elementor-column elementor-field-group-field_724c11f elementor-col-50 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_724c11f\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tLengte (cm)\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t<input type=\"number\" name=\"form_fields[field_724c11f]\" id=\"form-field-field_724c11f\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"195\" required=\"required\" min=\"\" max=\"\" >\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-date elementor-field-group elementor-column elementor-field-group-field_3adb557 elementor-col-50 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_3adb557\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tGeboortedatum\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\n\t\t<input type=\"date\" name=\"form_fields[field_3adb557]\" id=\"form-field-field_3adb557\" class=\"elementor-field elementor-size-sm  elementor-field-textual elementor-date-field elementor-use-native\" placeholder=\"DD-MM-JJJJ\" required=\"required\" pattern=\"[0-9]{4}-[0-9]{2}-[0-9]{2}\">\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_606707a elementor-col-50 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_606707a\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tBuikomvang (in cm)\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_606707a]\" id=\"form-field-field_606707a\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"102.5\" required=\"required\">\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-step elementor-field-group elementor-column elementor-field-group-field_d31685f elementor-col-100\">\n\t\t\t\t\t\t\t<div class=\"e-field-step elementor-hidden\" data-label=\"Gezondheid\" data-previousButton=\"\" data-nextButton=\"\" data-iconUrl=\"\" data-iconLibrary=\"fas fa-star\" data-icon=\"\" ><\/div>\n\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_51f2d73 elementor-col-100\">\n\t\t\t\t\t<div style=\"background:#f5f7f8;padding:15px;border-radius:8px;margin-bottom:20px;\">\n    <strong>Medische  gegevens<\/strong><br>\n    Vul hieronder de medische vragenlijst in zodat wij uw aanvraag kunnen verwerken.\n<\/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_2504725 elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_2504725\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tHeb je \u00e9\u00e9n of meer van onderstaande aandoeningen?\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<div class=\"elementor-field-subgroup  elementor-subgroup-inline\"><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"diabetes\" id=\"form-field-field_2504725-0\" name=\"form_fields[field_2504725][]\"> <label for=\"form-field-field_2504725-0\">Diabetes<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"hartfalen\" id=\"form-field-field_2504725-1\" name=\"form_fields[field_2504725][]\"> <label for=\"form-field-field_2504725-1\">Hartfalen<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"nierfunctie\" id=\"form-field-field_2504725-2\" name=\"form_fields[field_2504725][]\"> <label for=\"form-field-field_2504725-2\">Verminderde nierfunctie<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"leverfunctie\" id=\"form-field-field_2504725-3\" name=\"form_fields[field_2504725][]\"> <label for=\"form-field-field_2504725-3\">Verminderde leverfunctie<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"pancreatitis\" id=\"form-field-field_2504725-4\" name=\"form_fields[field_2504725][]\"> <label for=\"form-field-field_2504725-4\">Ontsteking van de alvleesklier (pancreatitis)<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"galblaas\" id=\"form-field-field_2504725-5\" name=\"form_fields[field_2504725][]\"> <label for=\"form-field-field_2504725-5\">Galstenen of galblaasproblemen<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"schildklier\" id=\"form-field-field_2504725-6\" name=\"form_fields[field_2504725][]\"> <label for=\"form-field-field_2504725-6\">Schildklieraandoening<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"hoge_bloeddruk\" id=\"form-field-field_2504725-7\" name=\"form_fields[field_2504725][]\"> <label for=\"form-field-field_2504725-7\">Hoge bloeddruk<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"schildklierkanker_familie\" id=\"form-field-field_2504725-8\" name=\"form_fields[field_2504725][]\"> <label for=\"form-field-field_2504725-8\">Familiaire voorgeschiedenis van schildklierkanker<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"men2\" id=\"form-field-field_2504725-9\" name=\"form_fields[field_2504725][]\"> <label for=\"form-field-field_2504725-9\">MEN2-syndroom (Multiple Endocrine Neoplasia type 2)<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"geen_van_bovenstaande\" id=\"form-field-field_2504725-10\" name=\"form_fields[field_2504725][]\"> <label for=\"form-field-field_2504725-10\">Geen van bovenstaande<\/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_8057cd4 elementor-col-100 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_8057cd4\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tZijn er nog andere medische aandoeningen die relevant kunnen zijn voor jouw behandeling?\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_8057cd4]\" id=\"form-field-field_8057cd4\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Bijvoorbeeld sreuma, auto-immuunziekte of andere aandoeningen.\" required=\"required\">\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_855ff6d elementor-col-100 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_855ff6d\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tBen je onder behandeling van een specialist? Zo ja, waarvoor?\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_855ff6d]\" id=\"form-field-field_855ff6d\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Bijvoorbeeld: diabetes, hoge bloeddruk, slaapapneu, etc.\" required=\"required\">\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-radio elementor-field-group elementor-column elementor-field-group-field_837012f elementor-col-50 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_837012f\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tGebruik je momenteel medicatie?\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=\"radio\" value=\"ja\" id=\"form-field-field_837012f-0\" name=\"form_fields[field_837012f]\" required=\"required\"> <label for=\"form-field-field_837012f-0\">Ja<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"nee\" id=\"form-field-field_837012f-1\" name=\"form_fields[field_837012f]\" required=\"required\"> <label for=\"form-field-field_837012f-1\">Nee<\/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_90b39ad elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_90b39ad\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tZo ja, welke medicatie?\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_90b39ad]\" id=\"form-field-field_90b39ad\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Bijvoorbeeld: Metformine, bloeddrukmedicatie, antidepressiva, etc.\">\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-radio elementor-field-group elementor-column elementor-field-group-field_93dd607 elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_93dd607\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tIndien vrouw, bent u of wilt u zwanger worden?\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=\"radio\" value=\"ja\" id=\"form-field-field_93dd607-0\" name=\"form_fields[field_93dd607]\"> <label for=\"form-field-field_93dd607-0\">Ja<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"nee\" id=\"form-field-field_93dd607-1\" name=\"form_fields[field_93dd607]\"> <label for=\"form-field-field_93dd607-1\">Nee<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"niet_van_toepassing\" id=\"form-field-field_93dd607-2\" name=\"form_fields[field_93dd607]\"> <label for=\"form-field-field_93dd607-2\">N.V.T.<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-radio elementor-field-group elementor-column elementor-field-group-field_da1d138 elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_da1d138\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tGeeft u borstvoeding\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=\"radio\" value=\"ja\" id=\"form-field-field_da1d138-0\" name=\"form_fields[field_da1d138]\"> <label for=\"form-field-field_da1d138-0\">Ja<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"nee\" id=\"form-field-field_da1d138-1\" name=\"form_fields[field_da1d138]\"> <label for=\"form-field-field_da1d138-1\">Nee<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"niet_van_toepassing\" id=\"form-field-field_da1d138-2\" name=\"form_fields[field_da1d138]\"> <label for=\"form-field-field_da1d138-2\">N.V.T.<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-step elementor-field-group elementor-column elementor-field-group-field_d7c0235 elementor-col-100\">\n\t\t\t\t\t\t\t<div class=\"e-field-step elementor-hidden\" data-label=\"Controle\" data-previousButton=\"\" data-nextButton=\"\" data-iconUrl=\"\" data-iconLibrary=\"fas fa-star\" data-icon=\"\" ><\/div>\n\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_fb8981e elementor-col-100\">\n\t\t\t\t\t<div style=\"background:#f5f7f8;padding:15px;border-radius:8px;margin-bottom:20px;\">\n    <strong>Medische  gegevens<\/strong><br>\n    Vul hieronder de laatste vragen in over uw streefgewicht, hoe lang u al bezig bent met uw gewicht zodat wij een gericht behandelplan kunnen opstellen.\n<\/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_a6feb0d elementor-col-100 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_a6feb0d\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tStreefgewicht\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_a6feb0d]\" id=\"form-field-field_a6feb0d\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" required=\"required\">\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-number elementor-field-group elementor-column elementor-field-group-field_a6537f7 elementor-col-100 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_a6537f7\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tHoelang probeer je al af te vallen? (in jaren)\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t<input type=\"number\" name=\"form_fields[field_a6537f7]\" id=\"form-field-field_a6537f7\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"5\" required=\"required\" min=\"0\" max=\"\" >\n\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-field_514af61 elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_514af61\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tWat heb je al geprobeerd om af te vallen?\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<div class=\"elementor-field-subgroup  elementor-subgroup-inline\"><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"nog_niets\" id=\"form-field-field_514af61-0\" name=\"form_fields[field_514af61][]\"> <label for=\"form-field-field_514af61-0\">Nog niets geprobeerd<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"sporten\" id=\"form-field-field_514af61-1\" name=\"form_fields[field_514af61][]\"> <label for=\"form-field-field_514af61-1\">Sporten en meer bewegen<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"dieet\" id=\"form-field-field_514af61-2\" name=\"form_fields[field_514af61][]\"> <label for=\"form-field-field_514af61-2\">Dieet of voedingsprogramma<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"dietist\" id=\"form-field-field_514af61-3\" name=\"form_fields[field_514af61][]\"> <label for=\"form-field-field_514af61-3\">Begeleiding door di\u00ebtist<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"andere_medicatie\" id=\"form-field-field_514af61-4\" name=\"form_fields[field_514af61][]\"> <label for=\"form-field-field_514af61-4\">Andere afslankmedicatie<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"anders\" id=\"form-field-field_514af61-5\" name=\"form_fields[field_514af61][]\"> <label for=\"form-field-field_514af61-5\">Anders<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-acceptance elementor-field-group elementor-column elementor-field-group-field_b6ed6f5 elementor-col-100 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_b6ed6f5\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tIk geef toestemming voor inzage in mijn medicatiegegevens via het LSP (Landelijk Schakelpunt). Deze toestemming is verplicht vanuit eFarma.\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-subgroup\">\n\t\t\t<span class=\"elementor-field-option\">\n\t\t\t\t<input type=\"checkbox\" name=\"form_fields[field_b6ed6f5]\" id=\"form-field-field_b6ed6f5\" class=\"elementor-field elementor-size-sm  elementor-acceptance-field\" required=\"required\">\n\t\t\t\t\t\t\t<\/span>\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-acceptance elementor-field-group elementor-column elementor-field-group-field_49b53d5 elementor-col-100 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_49b53d5\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tBevestig dat alle informatie naar waarheid is ingevuld:\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-subgroup\">\n\t\t\t<span class=\"elementor-field-option\">\n\t\t\t\t<input type=\"checkbox\" name=\"form_fields[field_49b53d5]\" id=\"form-field-field_49b53d5\" class=\"elementor-field elementor-size-sm  elementor-acceptance-field\" required=\"required\">\n\t\t\t\t\t\t\t<\/span>\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-group elementor-column elementor-field-type-submit elementor-col-100 e-form__buttons\">\n\t\t\t\t\t<button class=\"elementor-button elementor-size-md\" type=\"submit\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\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\">Verstuur <\/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\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-2b4131f elementor-widget-tablet__width-initial elementor-widget elementor-widget-text-editor\" data-id=\"2b4131f\" 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<h3>Hoe werkt het?<\/h3><ol><li><strong>Vul je gegevens in<\/strong><br \/>Wij gebruiken deze om te beoordelen of je in aanmerking komt voor een behandelplan.<\/li><li><strong>Weet binnen 24 uur of jij veilig met de medicatie kan starten.<\/strong><br \/>Binnen 1 werkdag ontvang je een betaallink als je in aanmerking komt<\/li><li><strong>Ons medisch team beoordeelt<\/strong><br \/>Een arts bekijkt jouw antwoorden en indien van toepassing, stelt hij direct een behandelplan op. Dit wordt met je besproken in een e-consult waarna de medicatie wordt besteld.<\/li><\/ol><p>Je gegevens worden uitsluitend gebruikt voor medische beoordeling en worden niet gedeeld met derden.<\/p>\t\t\t\t\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<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-33caaec\" data-id=\"33caaec\" data-element_type=\"column\" data-e-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<div class=\"elementor-element elementor-element-5c4a3ae elementor-widget-tablet__width-initial elementor-widget elementor-widget-text-editor\" data-id=\"5c4a3ae\" 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<div class=\"@container\/card-header grid auto-rows-min grid-rows-[auto_auto] items-start gap-1.5 px-6 pt-6 has-data-[slot=card-action]:grid-cols-[1fr_auto] [.border-b]:pb-6\" data-slot=\"card-header\"><h4 class=\"leading-none text-[var(--wc-primary-dark)]\" data-slot=\"card-title\">Waarom deze gegevens?<\/h4><\/div><div class=\"px-6 [&amp;:last-child]:pb-6\" data-slot=\"card-content\"><div class=\"space-y-4 text-sm\"><p class=\"text-gray-700\">We hebben je persoonlijke gegevens nodig om:<\/p><ul class=\"space-y-2 text-gray-600\"><li class=\"flex items-start gap-2\">Een medisch dossier aan te maken<\/li><li class=\"flex items-start gap-2\">Contact met je op te nemen indien nodig<\/li><li class=\"flex items-start gap-2\">Je medicatie op het juiste adres te bezorgen<\/li><li class=\"flex items-start gap-2\">Je identiteit te verifi\u00ebren<\/li><\/ul><p class=\"text-gray-700 pt-2\">Al je gegevens worden vertrouwelijk behandeld volgens de AVG-richtlijnen.<\/p><\/div><\/div>\t\t\t\t\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<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-b5c097f elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"b5c097f\" data-element_type=\"section\" data-e-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-50 elementor-top-column elementor-element elementor-element-95ef88b\" data-id=\"95ef88b\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-e3f6764 elementor-widget elementor-widget-text-editor\" data-id=\"e3f6764\" 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><strong>Weightconsults B.V.<br \/><\/strong>Postadres: Tingietersweg 90<br \/>Postcode: 2031 ES Haarlem<br \/>Telefoonnummer: <a href=\"tel:088-1232414\">088-1232414<\/a><br \/>E-mail: <a href=\"mailto:info@weightconsult.nl\" data-wplink-edit=\"true\">info@weightconsult.nl<\/a><br \/>KvK-nummer: 9798380<\/p>\t\t\t\t\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<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-93914d4\" data-id=\"93914d4\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-85a14ec elementor-widget elementor-widget-text-editor\" data-id=\"85a14ec\" 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>Apotheekgegevens: <b>Apotheek eFarma<br \/><\/b>Adres: Biesland 7<br \/>1948 RJ Beverwijk<br \/>Telefoonnummer: <a href=\"tel:0251-225525\">0251-225525<\/a><br \/>E-mail: <a href=\"mailto:klantenservice@efarma.nl\">klantenservice@efarma.nl<\/a><br \/>KvK-nummer: 34135482<\/p>\t\t\t\t\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<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Vul alle gegevens in voor behandelplan Start vandaag nog!\u00a0Vul je gegevens in en de medische vragen. Onze specialisten beoordelen direct of je kunt starten met een behandeltraject, je hoort binnen 24-uur of je kan beginnen en ontvangt als eerst een betaalverzoek. Daarna volgt het online consult en levering van de medicatie. \u2714 100% vrijblijvend\u2714 Binnen [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"site-sidebar-layout":"no-sidebar","site-content-layout":"page-builder","ast-site-content-layout":"full-width-container","site-content-style":"unboxed","site-sidebar-style":"unboxed","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"disabled","ast-breadcrumbs-content":"","ast-featured-img":"disabled","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"set","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"categories":[],"tags":[],"class_list":["post-2066","page","type-page","status-publish","hentry"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.5 - 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