Eruierungsgespräch

{"url":"\/eruierungsgespraech","form_action_on_submit":"display_text","form_action_on_submit_text":"Vielen Dank f\u00fcr das Einreichen des Formulars.","form_include_text_fields_in_notification_emails":null,"rows":[{"columns":[{"columnWidth":null,"fields":[{"field_id":"fcabf0a8-6f24-4149-8b1c-09286fa45310-field-2","field_name":"fcabf0a8-6f24-4149-8b1c-09286fa45310-field-2","field_type":"title","field_label":"Anrede","field_placeholder":"Ausw\u00e4hlen","clientField":"title"}]},{"columnWidth":null,"fields":[{"field_id":"fcabf0a8-6f24-4149-8b1c-09286fa45310-field-5","field_name":"fcabf0a8-6f24-4149-8b1c-09286fa45310-field-5","field_type":"spacer","height":"67px"}]}]},{"columns":[{"columnWidth":null,"fields":[{"field_id":"fcabf0a8-6f24-4149-8b1c-09286fa45310-field-3","field_name":"fcabf0a8-6f24-4149-8b1c-09286fa45310-field-3","field_type":"firstname","field_label":"Vorname*","field_placeholder":"Vorname","clientField":"firstname","field_required":"1","field_label_required_error":"","field_hidden":null}]},{"columnWidth":null,"fields":[{"field_id":"fcabf0a8-6f24-4149-8b1c-09286fa45310-field-4","field_name":"fcabf0a8-6f24-4149-8b1c-09286fa45310-field-4","field_type":"lastname","field_label":"Nachname*","field_placeholder":"Nachname","clientField":"lastname","field_required":"1","field_label_required_error":"","field_hidden":null}]}]},{"columns":[{"columnWidth":null,"fields":[{"field_id":"fcabf0a8-6f24-4149-8b1c-09286fa45310-field-6","field_name":"fcabf0a8-6f24-4149-8b1c-09286fa45310-field-6","field_type":"street","field_label":"Stra\u00dfe*","field_placeholder":"Stra\u00dfe","clientField":"street","field_required":"1","field_label_required_error":"","field_hidden":null}]},{"columnWidth":null,"fields":[{"field_id":"fcabf0a8-6f24-4149-8b1c-09286fa45310-field-7","field_name":"fcabf0a8-6f24-4149-8b1c-09286fa45310-field-7","field_type":"streetnr","field_label":"Hausnummer*","field_placeholder":"Hausnummer","clientField":"streetnr","field_required":"1","field_label_required_error":"","field_hidden":null}]}]},{"columns":[{"columnWidth":null,"fields":[{"field_id":"fcabf0a8-6f24-4149-8b1c-09286fa45310-field-8","field_name":"fcabf0a8-6f24-4149-8b1c-09286fa45310-field-8","field_type":"zipcode","field_label":"Postleitzahl*","field_placeholder":"Postleitzahl","clientField":"zipcode","field_required":"1","field_label_required_error":"","field_hidden":null}]},{"columnWidth":null,"fields":[{"field_id":"fcabf0a8-6f24-4149-8b1c-09286fa45310-field-9","field_name":"fcabf0a8-6f24-4149-8b1c-09286fa45310-field-9","field_type":"city","field_label":"Ort*","field_placeholder":"Ort","clientField":"city","field_required":"1","field_label_required_error":"","field_hidden":null}]}]},{"columns":[{"columnWidth":null,"fields":[{"field_id":"fcabf0a8-6f24-4149-8b1c-09286fa45310-field-10","field_name":"fcabf0a8-6f24-4149-8b1c-09286fa45310-field-10","field_type":"country","field_label":"Land*","field_placeholder":"Ausw\u00e4hlen","clientField":"country","field_required":"1","field_label_required_error":"","field_hidden":null}]},{"columnWidth":null,"fields":[{"field_id":"fcabf0a8-6f24-4149-8b1c-09286fa45310-field-56","field_name":"fcabf0a8-6f24-4149-8b1c-09286fa45310-field-56","field_type":"birthdate","field_label":"Geburtsdatum","field_placeholder":"Geburtsdatum","clientField":"birthdate"}]}]},{"columns":[{"columnWidth":null,"fields":[{"field_id":"fcabf0a8-6f24-4149-8b1c-09286fa45310-field-11","field_name":"fcabf0a8-6f24-4149-8b1c-09286fa45310-field-11","field_type":"email","field_label":"E-Mail*","field_placeholder":"E-Mail","clientField":"email","field_required":"1","field_label_required_error":"","field_hidden":null}]},{"columnWidth":null,"fields":[{"field_id":"fcabf0a8-6f24-4149-8b1c-09286fa45310-field-14","field_name":"fcabf0a8-6f24-4149-8b1c-09286fa45310-field-14","field_type":"mobile","field_label":"Mobiltelefon*","field_placeholder":"Handynummer","clientField":"mobile","field_required":"1","field_label_required_error":"","field_hidden":null}]}]},{"columns":[{"columnWidth":null,"fields":[{"field_id":"fcabf0a8-6f24-4149-8b1c-09286fa45310-field-25","field_name":"fcabf0a8-6f24-4149-8b1c-09286fa45310-field-25","field_type":"line"}]}]},{"columns":[{"columnWidth":null,"fields":[{"field_id":"fcabf0a8-6f24-4149-8b1c-09286fa45310-field-23","field_name":"fcabf0a8-6f24-4149-8b1c-09286fa45310-field-23","field_type":"radio","field_label":"Religi\u00f6se Fixierung*","field_placeholder":"","field_required":"1","field_label_required_error":"","field_hidden":null,"field_select_multiple":null,"field_label_no_option":"","options":[{"option_label":"ja","option_value":"","option_selected":false,"option_assigned_groups":null},{"option_label":"nein","option_value":"","option_selected":false,"option_assigned_groups":null}]},{"field_id":"fcabf0a8-6f24-4149-8b1c-09286fa45310-field-24","field_name":"fcabf0a8-6f24-4149-8b1c-09286fa45310-field-24","field_type":"textarea","field_label":"Wenn, ja. Welche?","field_placeholder":"Text","field_required":null,"field_label_required_error":"","field_hidden":null}]}]},{"columns":[{"columnWidth":null,"fields":[{"field_id":"fcabf0a8-6f24-4149-8b1c-09286fa45310-field-26","field_name":"fcabf0a8-6f24-4149-8b1c-09286fa45310-field-26","field_type":"line"}]}]},{"columns":[{"columnWidth":null,"fields":[{"field_id":"fcabf0a8-6f24-4149-8b1c-09286fa45310-field-27","field_name":"fcabf0a8-6f24-4149-8b1c-09286fa45310-field-27","field_type":"textarea","field_label":"Warum interessierst du dich f\u00fcr die Schneider Methode?","field_placeholder":"Text","field_required":null,"field_label_required_error":"","field_hidden":null}]}]},{"columns":[{"columnWidth":null,"fields":[{"field_id":"fcabf0a8-6f24-4149-8b1c-09286fa45310-field-28","field_name":"fcabf0a8-6f24-4149-8b1c-09286fa45310-field-28","field_type":"line"}]}]},{"columns":[{"columnWidth":null,"fields":[{"field_id":"fcabf0a8-6f24-4149-8b1c-09286fa45310-field-29","field_name":"fcabf0a8-6f24-4149-8b1c-09286fa45310-field-29","field_type":"textarea","field_label":"Woher kennen sie uns?","field_placeholder":"Text","field_required":null,"field_label_required_error":"","field_hidden":null}]}]},{"columns":[{"columnWidth":null,"fields":[{"field_id":"fcabf0a8-6f24-4149-8b1c-09286fa45310-field-30","field_name":"fcabf0a8-6f24-4149-8b1c-09286fa45310-field-30","field_type":"line"}]}]},{"columns":[{"columnWidth":null,"fields":[{"field_id":"fcabf0a8-6f24-4149-8b1c-09286fa45310-field-31","field_name":"fcabf0a8-6f24-4149-8b1c-09286fa45310-field-31","field_type":"textarea","field_label":"Art und Dauer der Beschwerten","field_placeholder":"Text","field_required":null,"field_label_required_error":"","field_hidden":null}]}]},{"columns":[{"columnWidth":null,"fields":[{"field_id":"fcabf0a8-6f24-4149-8b1c-09286fa45310-field-32","field_name":"fcabf0a8-6f24-4149-8b1c-09286fa45310-field-32","field_type":"line"}]}]},{"columns":[{"columnWidth":null,"fields":[{"field_id":"fcabf0a8-6f24-4149-8b1c-09286fa45310-field-34","field_name":"fcabf0a8-6f24-4149-8b1c-09286fa45310-field-34","field_type":"text","text":"<p>Narben<\/p><p>Zu Narben z\u00e4hlen: Risse, Schnitte, Stiche (auch Impfungen\/Pocken), Dammschnitt, Operationen aller Art (auch unsichtbare wie Tonsillen, Unterleibsoperationen etc.) Quetschungen, Br\u00fcche, starke Prellungen, Gehirnerch\u00fctterungen, Verstauchungen, B\u00e4nderverletzungen, intensive Entz\u00fcndungen (Lungenentz\u00fcndung etc.), Schl\u00e4ge, Kindheitsverletzungen und Erkrankungen, Zahnextraktionen (auch nach Zysten, Eiterherden), Implantate, Verbrennungen, Erfrierungen.<br>Achtung, auch Amalgamf\u00fcllungen, Implantatmaterialien oder starke Medikamente angeben. <br><\/p>"}]}]},{"columns":[{"columnWidth":null,"fields":[{"field_id":"fcabf0a8-6f24-4149-8b1c-09286fa45310-field-35","field_name":"fcabf0a8-6f24-4149-8b1c-09286fa45310-field-35","field_type":"textarea","field_label":"Kopfbereich\/Hals (inkl. 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H\u00fcften, Adduktorenzerrungen, Arthroskopie, Halux Valgus, H\u00fchnerauge)","field_placeholder":"Text","field_required":null,"field_label_required_error":"","field_hidden":null}]}]},{"columns":[{"columnWidth":null,"fields":[{"field_id":"fcabf0a8-6f24-4149-8b1c-09286fa45310-field-39","field_name":"fcabf0a8-6f24-4149-8b1c-09286fa45310-field-39","field_type":"textarea","field_label":"Bisherige medizinische 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bin mit der Speicherung meiner Daten einverstanden.","option_value":"","option_selected":false,"option_assigned_groups":null}]}]},{"columnWidth":null,"fields":[{"field_id":"fcabf0a8-6f24-4149-8b1c-09286fa45310-field-17","field_name":"fcabf0a8-6f24-4149-8b1c-09286fa45310-field-17","field_type":"text","text":"<p class=\"p-small\">Detaillierte Informationen zum Umgang mit Nutzerdaten finden Sie in unserer <a href=\"\/datenschutz\" target=\"_blank\">Datenschutzerkl\u00e4rung<\/a>. Sie k\u00f6nnen Ihre Einwilligung jederzeit per E-Mail widerrufen an: info@schneidermethode.com<\/p>"}]}]},{"columns":[{"columnWidth":null,"fields":[{"field_id":"fcabf0a8-6f24-4149-8b1c-09286fa45310-field-1","field_name":"fcabf0a8-6f24-4149-8b1c-09286fa45310-field-1","field_type":"button","field_label":"Absenden","buttonClasses":"wsw-block-button-default wsw-button-solid wsw-button-pill wsw-button-meduim"}]}]}]}

{"no_option":"Keine Option","subscribe_to_newsletter":"Newsletter abonnieren","subscribe_to_newsletter_yes":"Ja","subscribe_to_newsletter_no":"Nein","send_form_to_me_label":"Kopie an mich senden","choose_file":"Datei ausw\u00e4hlen","invalid_email":"E-Mail ist nicht korrekt","email_does_not_match":"E-Mail stimmt nicht \u00fcberein","password_does_not_match":"Passwort stimmt nicht \u00fcberein","captcha_failed":"Captcha-Verifikation fehlgeschlagen. Bitte versuchen Sie es erneut.","field_required":"Dieses Feld ist notwendig","unknown_error":"Unbekannter Error. Bitte neu laden","on_submit_text":"Vielen Dank f\u00fcr das Einreichen des Formulars."}